Solitary Fibrous Tumour in the Head and Neck Region – A Systematic Review

Abstract

Solitary fibrous tumours (SFTs) are rare mesenchymal neoplasms with variable clinical behaviour, increasingly reported in the head and neck region. This systematic review evaluates their presentation across diverse anatomical sites such as the orbit, sinonasal tract, cranial base, and salivary glands. The majority of patients present with painless, slow-growing masses, and diagnosis is often challenging due to overlapping histologic features with other spindle cell tumours. Immunohistochemistry, particularly nuclear STAT6 expression, plays a critical role in confirming the diagnosis.

Complete surgical excision with negative margins remains the primary treatment, with recurrence reported in up to 15% of cases—often occurring years after initial therapy. Malignant histological features such as increased mitotic activity and tumour necrosis are associated with higher recurrence risk, although not always predictive. Given the potential for late relapse and site-specific challenges, long-term follow-up and a multidisciplinary approach are essential for optimal management of head and neck SFTs.