Transnasal Endoscopic Resection of a Huge Solitary Fibrous Tumor Originated from Frontal Recess

Abstract

Solitary fibrous tumor (SFT) is a rare neoplasm also known as benign fibrous mesothelioma or submesothelial fibroma. It was first described as a primary spindle cell tumor of the pleura by Klemperer and Rabin in 1931. SFTs were initially thought to be originated from mesothelium, but later studies showed them to arise from mesenchyme. SFTs mostly arise from the pleura, but they are also found in various extra-pleural sites including the abdomen, extremities, and vulva. SFTs in the head and neck area have been reported in several studies, but occurrence in nasal cavity and paranasal sinus is still extremely rare. The patients are usually presented with well-defined soft tissue mass initially causing no symptoms but later resulting in various symptoms such as nasal obstruction, epistaxis, hyposmia, and facial pain due to the mass effect. For the diagnosis of SFT, computed tomography (CT), magnetic resonance imaging (MRI), and biopsy for pathologic results with immunohistochemical stains are usually performed. Once the SFTs are diagnosed, complete surgical excision is the treatment of choice. In this case, we report a huge SFT originated from the frontal recess and extended to nasal cavity, which was successfully excised by transnasal endoscopic tumor removal.