Extensive solitary fibrous tumor of the retropharyngeal space.

Abstract

Solitary fibrous tumor (SFT) is a rare neoplasm whose histologic diagnosis poses significant problems in differential diagnosis. Although most of these neoplasms arise at the level of the pleura, there have also been reports of extrapleural origins. The most frequent localization in the head and neck region is in the nasal cavity. We describe the case of an 81-year-old patient with an SFT that arose in the retropharyngeal space. Symptoms were solid food dysphagia associated with modest dyspnea. Physical examination revealed the presence on the posterior pharyngeal wall of an apparently circumscribed, multilobed mass, which was compact in consistency and partially obstructed the upper aerodigestive tract. After radiologic assessment to carefully evaluate its size and relationship to surrounding structures, the tumor was surgically removed. The importance of immunohistochemical findings in the histologic differential diagnosis are discussed. Follow-up plays a crucial role in evaluating the possible recurrence of such tumors, because parameters for determining their aggressiveness are still controversial.