Stylianos N Zanakis* and Megas FV
1Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, “Hippokration” General Hospital of Athens, Greece
2Otorhinolaryngologist, Private practice, Greece
Received: 25 January, 2017; Accepted: 30 January, 2017; Published: 31 January, 2017
Stylianos N Zanakis, Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, “Hippokration” General Hospital of Athens, Greece, Tel: +30- 213-208-8000; E-mail:
Zanakis SN, Megas FV (2017) A Unique Case: Solitary Fibrous Tumor of the Mandible. Int J Oral Craniofac Sci 3(1): 005-007. 10.17352/2455-4634.000023
© 2017 Zanakis SN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Solitary fibrous tumors (SFTs) were firstly reported in the pleura by Klemperer and Rabin , in 1931. These tumors are rare lesions and most commonly arise in the thoracic cavity . Most of them occur as slow-growing painless masses. Rarely, larger tumors may be a source of paraneoplastic syndromes such as hypoglycemia owing to the production of insulin-like growth factor [3,4]. SFT is a mesenchymal neoplasm, previously nomenclatured as localized benign mesothelioma, submesothelioma, or localized fibrous tumor of the pleura . It is now recognized that this may also occurs in extrapleural sites. Recently, however, SFT has been shown to originate from ubiquitous interstitial stem cells in various human tissues and its histopathological criteria have been established by the aid of immunohistochemistry . SFTs arising in the soft tissue of the head and neck account for approximately 10% of all cases . Those occurring in the oral cavity accounts for 3% of all head and neck cases . In the present report we describe the occurrence of a SFT case in the angle region of the mandible. This is the first case report of a SFT arising in the mandible.
A 71-year-old Caucasian male patient attended the outpatient department complaining of a swelling in his left lower jaw. The mass was painless and noticed by the patient 5 months ago. Extraoral examination showed a slight fullness of his lower left face. Clinically there was no cervical lymphadenopathy. Hypoaesthesia was evident in the region of distribution of the left inferior alveolar nerve. Intraorally, the lesion, firm in palpation, occupied the mandible from the first molar to the ascending ramus, expanding the buccal and lingual plates. The swelling was covered by healthy mucosa. The Orthopantomogram revealed a diffuse, poorly demarcated endosseous lesion in the region of the left mandibular angle (Figure 1). The computed tomography scan (CT) depicted an endosseous destructive lesion, measured 4.4 x 3.4 cm, causing expansion of the left mandible in all directions, destruction of both plates and lingual extraosseous extension (Figures 2,3). A Fine Needle Aspiration Cytology of the lesion was performed, showing malignant features, yet not specified otherwise. An incisional biopsy followed. The histopathology report indicated either a low grade osteosarcoma or a solitary fibrous tumor with malignant component. The distant metastases work up was negative. The patient under general anesthesia underwent a segmental mandibulectomy via a submandibular approach. The adjacent soft tissues were resected in clinically healthy tissues. The mandible was reconstructive using a 13-hole titanium plate. The postoperative period was uneventful. The patient had been examined regularly on an outpatient basis for one and a half year. At that time there was no clinical evidence of tumor recurrence and a CT scan was negative for findings. Unfortunately, thereafter the patient failed to attend the outpatient clinic.