Solitary fibrous tumor of the oral cavity with a predominant leiomyomatous-like pattern: A potential diagnostic pitfall

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• 作者：Paolo Amico ; Giuseppe Colella ; Raffaele Rossiello ; Giada Maria Vecchio ; Pietro Leocata ; Gaetano Magro
• 关键词：Solitary fibrous tumor ; Oral cavity ; Leiomyoma ; Differential diagnosis ; Immunohistochemistry
• 刊名：Pathology - Research and Practice
• 出版年：2010
• 出版时间：15 July 2010
• 年：2010
• 卷：206
• 期：7
• 页码：499-503
• 全文大小：2648 K

文摘

The diagnosis of solitary fibrous tumor (SFT) is usually straightforward if the typical morphologic features, including a wide variety of growth patterns, are identified. We report the clinical, radiologic, and pathologic findings of a rare case of intraoral SFT which exhibited a predominant leiomyomatous-like appearance, closely reminiscent of a leiomyoma, at both incisional and excisional biopsy. Histologically, the tumor was composed predominantly of intersecting fascicles of eosinophilic spindle-shaped cells, variably set in a fibrous stroma. A focal hemangiopericytoma-like growth pattern with alternating hypercellular and hypocellular areas, as well as the deposition of dense keloid-type collagen, raising the suspicion of SFT, could be identified only after a careful examination of the whole tumor. Immunohistochemistry was helpful in confirming the diagnosis of SFT, revealing a diffuse staining of neoplastic cells for vimentin, CD34, bcl-2 protein, and, focally, CD99. Myogenic markers (α-smooth muscle actin, desmin, h-caldesmon) were not expressed.

The pathologist should be aware of this variant of intraoral leiomyomatous-like SFT to avoid a misdiagnosis of leiomyoma. The distinction of SFT from leiomyoma in the oral cavity is important to assure both correct treatment and prognostic information.