Primary radiotherapy for intraorbital solitary fibrous tumor: a case report with 5-year follow-up

Orbital solitary fibrous tumors (OSFTs) are rare, usually benign spindle-cell neoplasms predominantly treated with complete surgical excision. In cases where the tumor is anatomically complex or surgical morbidity is high, alternative therapies may be considered. Here we report, to our knowledge, the first case of an OSFT successfully managed with primary stereotactic radiotherapy. The patient, a 69-year-old woman, showed sustained tumor regression and clinical improvement over a 5-year follow-up period without evidence of malignant transformation. This case demonstrates that primary radiotherapy may be a safe and effective alternative in select OSFT cases where surgery poses risks.