경구개 접근법으로 절제한 익구개와의 거대 고립성 섬유종 1예
Resection Via Transpalatal Approach of Huge Solitary Fibrous Tumor Involving Pterygopalatine Fossa
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초록
Solitary fibrous tumors (SFTs) are spindle-cell tumors that rarely arise within extrathoracicarea. Massive SFTs involving the pterygopalatine fossa are extremely rare and surgical excisionrepresents a multidisciplinary surgical challenge. We present a case of 64-year-old femalewith a huge mass originating from the pterygopalatine fossa invading the skull base. Distinctmicroscopic findings and a positive nuclear staining of signal transducer and activator of transcription6 (STAT-6) pathologically confirmed SFT. The right internal maxillary arterybranch was embolized preoperatively and a surgical excision was performed through a combinedtechnique of transpalatal, mid-facial degloving and endoscopic approach. Postoperativeradiotherapy successfully removed the remnant tumor adjacent to the carvenous sinus. Follow-up MR images showed no evidence of recurrence for two years. To our knowledge, therehas been no previous report of the successful treatment of this vast extent of SFT in the pterygopalatineregion via endoscopic-external-combined approach and radiotherapy.
Abstract
Solitary fibrous tumors (SFTs) are spindle-cell tumors that rarely arise within extrathoracicarea. Massive SFTs involving the pterygopalatine fossa are extremely rare and surgical excisionrepresents a multidisciplinary surgical challenge. We present a case of 64-year-old femalewith a huge mass originating from the pterygopalatine fossa invading the skull base. Distinctmicroscopic findings and a positive nuclear staining of signal transducer and activator of transcription6 (STAT-6) pathologically confirmed SFT. The right internal maxillary arterybranch was embolized preoperatively and a surgical excision was performed through a combinedtechnique of transpalatal, mid-facial degloving and endoscopic approach. Postoperativeradiotherapy successfully removed the remnant tumor adjacent to the carvenous sinus. Follow-up MR images showed no evidence of recurrence for two years. To our knowledge, therehas been no previous report of the successful treatment of this vast extent of SFT in the pterygopalatineregion via endoscopic-external-combined approach and radiotherapy.
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