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Volume 15
Issue 21
10.3390/diagnostics15212721
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Article

The Solitary Fibrous Tumor, the Chameleon of the Head and Neck Region—Clinical, Epidemiological, and Histopathological Aspects

by
Marina Rakitovan
1,2,3,
Adrian Nicoara
2,4,*,
Raluca Maria Closca
1,3,5,
Raluca Amalia Ceausu
1,3,
Cristina Stefania Dumitru
1,3,
Alina Cristina Barb
1,3,
Dorin Novacescu
1,3,
Antonia Armega Anghelescu
1,
Alexandru Cristian Cindrea
6,7 and
Flavia Zara
1,3,5
1
Department of Microscopic Morphology, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
2
Oro-Maxillo-Facial Surgery Clinic, Emergency City Hospital, 300062 Timisoara, Romania
3
Angiogenesis Research Center, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
4
Discipline of Dentoalveolar Surgery, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
5
Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania
6
Doctoral School, Faculty of General Medicine, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
7
Emergency Clinical Municipal Hospital, 300254 Timisoara, Romania
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(21), 2721; https://doi.org/10.3390/diagnostics15212721 (registering DOI)
Submission received: 18 September 2025 / Revised: 9 October 2025 / Accepted: 23 October 2025 / Published: 27 October 2025
(This article belongs to the Special Issue Pathology and Diagnosis of Head and Neck Diseases)
Versions Notes

Abstract

Background/Objectives: The solitary fibrous tumor is an uncommon benign mesenchymal neoplasm with relatively indolent and rarely metastasizing behavior. This retrospective study includes 26 cases of head and neck solitary fibrous tumors diagnosed between 2017 and 2024. Methods: The morphological examination with Hematoxylin–Eosin staining was completed via immunohistochemical reactions with specific antibodies. Results: The Ki-67 proliferation index had a median of 11.2%, with an interquartile range of 5% to 15%. CD20-positive B-cells had a score of 0 in 50% of cases (n = 26), while CD3 and CD5 T-cells had a score of 3 in 81% of cases (n = 21). CD4-positive T-cells had a majority score of 1 (81%, n = 21). CD8-positive T-cells had a broader distribution: 65% (n = 17) of cases presented a score of 1, 27% (n = 7) a score of 2, and 8% (n = 8) a score of 0. Antigen-presenting dendritic cells and mast cells presented a majority score of 0 in the entire cohort, being undetectable in 85% (n = 22) and 88% (n = 23) of cases, respectively. CD20-positive B-lymphocytes demonstrated moderately strong correlations with the Ki-67 cell proliferation index (r = 0.77). The time to recurrence was most strongly associated with the Ki-67 mitotic index (r = 0.81), CD4-positive (r = 0.85), and CD5-positive T-lymphocytes (r = 0.55), and CD20-positive B-lymphocyte expression (r = 0.68). Conclusions: This research illustrates our experience with head and neck solitary fibrous tumors, the surgical decisions, and the morphological and immunohistochemical features, while reviewing the cases published in English in the specialized literature.
Keywords: head and neck pathology; maxillofacial pathology; oral pathology; solitary fibrous tumor; mesenchymal tumors; immunohistochemical reaction head and neck pathology; maxillofacial pathology; oral pathology; solitary fibrous tumor; mesenchymal tumors; immunohistochemical reaction

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MDPI and ACS Style

Rakitovan, M.; Nicoara, A.; Closca, R.M.; Ceausu, R.A.; Dumitru, C.S.; Barb, A.C.; Novacescu, D.; Armega Anghelescu, A.; Cindrea, A.C.; Zara, F. The Solitary Fibrous Tumor, the Chameleon of the Head and Neck Region—Clinical, Epidemiological, and Histopathological Aspects. Diagnostics 2025, 15, 2721. https://doi.org/10.3390/diagnostics15212721

AMA Style

Rakitovan M, Nicoara A, Closca RM, Ceausu RA, Dumitru CS, Barb AC, Novacescu D, Armega Anghelescu A, Cindrea AC, Zara F. The Solitary Fibrous Tumor, the Chameleon of the Head and Neck Region—Clinical, Epidemiological, and Histopathological Aspects. Diagnostics. 2025; 15(21):2721. https://doi.org/10.3390/diagnostics15212721

Chicago/Turabian Style

Rakitovan, Marina, Adrian Nicoara, Raluca Maria Closca, Raluca Amalia Ceausu, Cristina Stefania Dumitru, Alina Cristina Barb, Dorin Novacescu, Antonia Armega Anghelescu, Alexandru Cristian Cindrea, and Flavia Zara. 2025. "The Solitary Fibrous Tumor, the Chameleon of the Head and Neck Region—Clinical, Epidemiological, and Histopathological Aspects" Diagnostics 15, no. 21: 2721. https://doi.org/10.3390/diagnostics15212721

APA Style

Rakitovan, M., Nicoara, A., Closca, R. M., Ceausu, R. A., Dumitru, C. S., Barb, A. C., Novacescu, D., Armega Anghelescu, A., Cindrea, A. C., & Zara, F. (2025). The Solitary Fibrous Tumor, the Chameleon of the Head and Neck Region—Clinical, Epidemiological, and Histopathological Aspects. Diagnostics, 15(21), 2721. https://doi.org/10.3390/diagnostics15212721

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