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To present a case series of patients with Solitary Fibrous Tumor (SFT) of the orbit which represents a very rare entity.

Retrospective case series of 7 patients with orbital SFT treated between 2010 and 2018 at a tertiary referral center in UK were included in this study. Clinical, radiological, histopathological features and management outcome of patients with orbital SFT were recorded. Recurrences and malignant transformation were evaluated. A correlation between radiological, clinical and histological features was performed as to identify outcome predictors of malignant transformation or local recurrence.

7 patients (4 males and 3 females) with a mean age of 51 years (range: 21-87) were included to our study. Mean time of presentation of symptoms was 5 months (range: 2-12). Painless proptosis was the initial presentation in 4 cases while in 3 cases the initial main symptom was lid swelling with the presence of a firm mass in the orbital rim. 2 patients had restricted motility on presentation. Mean follow up period was 5 years (range: 3-9). Histopathology and immunohistochemistry studies were performed. All tumors were positive for CD34. Complete excisional biopsy was performed in 3 cases while a debulking biopsy was performed in the remainder 4 cases. 2 patients required more than one biopsy due to local recurrences. One case had malignant transformation and exenteration was performed. No surgical complication was noted in our study group.

Solitary fibrous tumor is a rare mesenchymal tumor which rarely involves the orbit. Malignant transformation is uncommon however, whenever diagnosed can have devastating consequences. Long term follow-up with routine MRI of the orbits is mandatory.