Solitary Fibrous Tumor Treatment & Management

Updated: May 31, 2023
  • Author: Vincent Y Ng, MD; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Nonoperative Therapy

No evidence suggests that adjuvant chemotherapy is beneficial. In nondedifferentiated SFTs, antiangiogenic agents appear to be more effective than chemotherapy. Pazopanib is recommended as first-line antiangiogenic therapy on the basis of its favorable toxicity profile and the efficacy derived from a phase II trial. [2] At the time of progression, rotating antiangiogenics is a reasonable approach. Other antiangiogenics, such as sunitinib and axitinib, have demonstrated activity in SFT and could be used sequentially.

If the SFT appears malignant histologically, adjuvant radiation therapy (RT) may be considered. 


Surgical Therapy

Because even benign-appearing solitary fibrous tumors (SFTs) can be locally recurrent and metastatic, wide resection is recommended for both benign and malignant SFTs. Preoperative vascular studies and arterial embolization should be considered because of the known bleeding risk with resection. [3, 15] Careful exclusion of other diagnoses (eg, synovial sarcoma) is important. Because of the favorable outcome with SFTs, it may be possible to avoid limb-threatening and deforming operations. [5]

Long-term follow-up is recommended because local and distant relapse is possible, even with benign-appearing tumors.