Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

A Rare Case of Solitary Fibrosus Tumor (SFT) of the Nasal Septum

Document Type : Case Report

Authors
Davide Burrascano
Salvatore Dolores
Angelo Immordino
Francesco Lorusso
Francesco Dispenza
Federico Sireci
Department of Biomedicine, Neuroscience and Advanced Diagnostics, AOUP Paolo Giaccone, University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy.
10.22038/ijorl.2023.72285.3450
Abstract
Introduction:
Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that usually arises from the pleura but can also occur in extrapleural sites, such as the sinonasal region. It causes  aspecific symptoms, including nasal obstruction and discharge, postnasal drip, anosmia, epistaxis, and headache. It may be difficult to distinguish these symptoms from those caused by other mesenchymal lesions that usually occur in this site, especially when the tissues undergo iatrogenic damage following surgical removal.
Case Report:
This case report shows a rare right nasal septal solitary fibrous tumor, which was surgically removed using a trans-nasal endoscopic technique. For the first time, the mass was decomposed by a plasma blade, and the implant site was treated by performing a subperiosteal removal of septal mucosa and cartilage. Histopathological examination confirmed the diagnosis of solitary fibrous tumor. Follow-up at three, six, and twelve months showed no signs of relapse.
Conclusions:
Sinonasal SFT is unusual, and it may be difficult to distinguish it from other mesenchymal lesions in this site. In the literature, cases treated with CO2 laser are usually described; however, due to the high cutting temperatures, this can cause thermal damage of the tissues, making histopathological diagnosis difficult. The plasma blade uses pulsed radiofrequency, creating an effective cutting edge while the blade stays near body temperature. Therefore, this device results in atraumatic, scalpel-like cutting sensitivity and electrosurgical-like hemostasis, with minimal bleeding and tissue injury. Its use could, therefore, help both the surgeon in obtaining surgical radicality and the pathologist in the correct histologic classification.
Keywords
Solitary fibrosus tumor
nasal tumors
differential diagnosis
nasal surgery
plasma blade
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 35, Issue 6
November and December 2023
Pages 329-334