Solitary Fibrous Tumors of the Head and Neck: A Report of Two Cases and Review of the Literature

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, particularly uncommon in the cheek and floor of the mouth. We report two such cases to emphasize diagnostic and management considerations. A retrospective review at a tertiary academic hospital included two female patients aged 40 and 49 years. Both underwent clinical evaluation, radiologic imaging, surgical excision, and histopathologic assessment with immunohistochemistry, including STAT6, CD34, BCL2, and CD99. Risk stratification was based on mitotic index and histological features. The first case involved a 40-year-old woman with a 3.5 × 2 × 1.5 cm lesion in the floor of the mouth. Histopathology confirmed SFT with STAT6, CD34, BCL2, and CD99 positivity; the mitotic rate was 1/10 HPF, consistent with low risk. The second case involved a 49-year-old woman with a 1.5 × 1.5 cm right cheek mass, also confirmed as SFT with a similar immunoprofile and negligible mitotic activity, indicating very low risk. Both patients underwent complete excision and recovered uneventfully, with no recurrence on a two-week follow-up. These cases illustrate that SFTs, though rare in the cheek and floor of the mouth, should be considered in the differential diagnosis of soft tissue tumors. Diagnosis depends on histopathology and immunohistochemistry, particularly STAT6. Complete excision is usually curative, but long-term surveillance remains essential.