Malignant solitary fibrous tumor of the infratemporal fossa

Solitary fibrous tumors (SFTs) of the head and neck are very rare, with less than 600 reported cases in English literature. We present a case of a 37-year-old female with a diagnosis of malignant solitary fibrous tumor (MSFT) of the infratemporal fossa. The patient underwent a right partial maxillectomy and resection of a right infratemporal fossa lesion via transoral approach as well as post-operative radiation therapy. Several months after radiation, the patient developed swelling of the right temporal region with displacement and swelling of the right eye that correlated to her complaint of worsening diplopia. The patient was found to have another tumor mass in the right temporal region with invasion of the temporal bone and lateral orbit wall as well as metastasis to the lungs and neck. A radical resection of the right temporal tumor with free flap reconstruction was performed. The patient tolerated the surgery well and is undergoing adjuvant chemotherapy. This is the fourth case of a MSFT of the infratemporal fossa known in the literature. Due to the rarity of MSFTs, prognosis and adjuvant therapy have not been fully investigated. The current best management of the patient is long-term close follow-up.