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Glauser G, Sharma N, Kritikos M, Malhotra NR, Choudhri O. Cervical, Intradural Extramedullary Solitary Fibrous Tumor of the Spinal Cord: A Case Report and Review of the Literature. Asian J Neurosurg 2020; 15:204-209. [PMID: 32181204 PMCID: PMC7057895 DOI: 10.4103/ajns.ajns_213_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/25/2019] [Indexed: 12/18/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare, spindle cell neoplasms of the mesenchymal origin. Lesions localized to the spine are exceptionally uncommon, only described in the literature in case reports and small case series. While these lesions are typically benign, there are a few reports in which they recur or present as malignancies. The patient presented in the case herein was a 72-year-old male, who presented with a 1-year history of lower extremity weakness, pain, and numbness and was found to have a cervical, intradural extramedullary tumor. In addition to the case report, the authors perform a thorough review of all previously published cases of spinal SFT.
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Affiliation(s)
- Gregory Glauser
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Sharma
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Kritikos
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil Rainer Malhotra
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Omar Choudhri
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Abstract
RATIONALE Solitary fibrous tumor (SFT) is an unusual neoplasm, especially when it originates from the seminal vesicle. Herein, we describe a case of SFT that arises from the seminal vesicle. PATIENT CONCERNS A 66-year-old man presented to our hospital complaining of a huge irregular tumor in his pelvis during a health checkup. He was worried that the tumor could be a malignant tumor and hence wanted to undergo further examination and therapy. DIAGNOSIS An inhomogeneous, mixed soft tissue tumor in the pelvis was found during computed tomography (CT) and magnetic resonance imaging. The tumor showed heterogeneous and delayed enhancement during contrast-enhanced CT. The tumor was diagnosed as a cystadenoma originated from the seminal vesicle due to its imaging features. But the pathological diagnosis was SFT that originated from the seminal vesicle. INTERVENTIONS Laparoscopic seminal vesicle tumor resection was performed. OUTCOMES There was no evidence of recurrence at the 6-month follow-up. LESSONS SFT in the seminal vesicle is extremely rare. It is very difficult to distinguish SFT in the seminal vesicle from the primary tumors as both have similar imaging features. We describe the tumor with SFT being considered as a differential diagnosis when the tumor is found in the seminal vesicle.
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Wang Y, Wei R, Ji T, Chen Z, Guo W. Surgical treatment of primary solitary fibrous tumors involving the pelvic ring. PLoS One 2018; 13:e0207581. [PMID: 30481195 PMCID: PMC6258478 DOI: 10.1371/journal.pone.0207581] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/03/2018] [Indexed: 12/02/2022] Open
Abstract
The surgical treatment of primary solitary fibrous tumors (SFT) involving the pelvic ring has not been reported previously. In this study, we aimed to evaluate the efficacy of surgical treatment for this disease. From 2009 to 2015, 13 patients underwent tumor resection at our hospital, with an average age of 49.5 years (27–68 years). Four patients underwent en bloc resection, and 9 patients underwent piecemeal resections. A Chi-square test was used to compare the postoperative recurrence rates between the en bloc resection and the piecemeal resection groups (p = 0.68), and no significant difference was found between the benign and malignant solitary fibrous tumor groups (p = 0.44). The 5-year survival rate of the patients in this study was 83.3%, and the 5-year progression-free survival rate was 63.5%. The progression-free survival rate was not significantly different between the en bloc resection and piecemeal resection groups (p = 0.97). Piecemeal resection can also achieve acceptable local control, particularly for patients with sacral tumors, as they may achieve even better postoperative function with sacral nerve preservation. Recurrence and metastasis occur relatively late in the course of this disease. Therefore, long-term follow-up is required.
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Affiliation(s)
- Yifei Wang
- Department of Musculoskeletal Tumors, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Ran Wei
- Department of Musculoskeletal Tumors, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Tao Ji
- Department of Musculoskeletal Tumors, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Zhongyan Chen
- Department of Musculoskeletal Tumors, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Wei Guo
- Department of Musculoskeletal Tumors, Peking University People’s Hospital, Beijing, People’s Republic of China
- * E-mail:
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Abstract
RATIONALE Solitary fibrous tumors (SFTs) are rare spindle cell tumors that are most commonly found in the mediastinal pleura. Although there are increasingly more reports of extra-pleural SFTs, reports of SFTs in bone are very rare. To our knowledge, a SFT of the ilium has not yet been reported. With low specificity on computer tomograpy and magnetic resonance imaging, SFTs are easily misdiagnosed. PATIENT CONCERNS A 33-year-old man visited our hospital due to repeated right ilium pain for 3 months. The pain was dull and bearable, with no hip joint dyskinesia. The relevant physical examinations are negative. The patient was healthy before and had a negative family history. Radiologically, a large mass with inhomogeneous attenuation and intensity and obvious heterogeneous enhancement was misdiagnosed as a giant cell tumor of ilium. DIAGNOSES The man was diagnosed as the solitary fibrous tumor of right ilium. INTERVENTIONS The patient was performed an "incision biopsy of the right ilium" and "extended resection of tumor". OUTCOMES The pathology and immunohistochemistry was confirmed as the solitary fibrous tumors. The patient was followed-up by computed tomography of pelvis in local hospital every 6 mouths, and there is no recurrence and any symptoms. LESSONS We learned that the solitary fibrous tumor could locate in the ilium, and when we see imaging manifestations like this case, we should think it may be SFT.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang Province
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Jinsheng Liao
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Ryan Justin Choo
- Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Juncheng Yan
- Department of Radiology, the Fourth Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Jingfeng Zhang
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
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Spinal Solitary Fibrous Tumor/Hemangiopericytoma: A Clinicopathologic and Radiologic Analysis of Eleven Cases. World Neurosurg 2017; 104:318-329. [DOI: 10.1016/j.wneu.2017.05.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 12/20/2022]
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Albert GW, Gokden M. Solitary fibrous tumors of the spine: a pediatric case report with a comprehensive review of the literature. J Neurosurg Pediatr 2017; 19:339-348. [PMID: 28106515 DOI: 10.3171/2016.10.peds16279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Solitary fibrous tumors of the spine are rare lesions. Their description in the literature is limited to case reports and small case series. While generally benign lesions, they can recur and occasionally occur as malignancies. Here the authors present the case of a 10-year-old boy, the youngest patient and first preadolescent reported thus far, with this condition. In addition, they perform a comprehensive review of all previously published cases of spinal solitary fibrous tumors.
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Affiliation(s)
- Gregory W Albert
- Division of Neurosurgery, Arkansas Children's Hospital; and.,Departments of 2 Neurosurgery and
| | - Murat Gokden
- Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Zaldivar-Jolissaint JF, Mascott C, Gugliotta M, Duff JM. Extensive bone remodeling from a solitary fibrous tumor of the cervical spine. Spine J 2016; 16:e699-e700. [PMID: 26997109 DOI: 10.1016/j.spinee.2016.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 02/03/2023]
Affiliation(s)
| | - Christopher Mascott
- Division of Neurosurgery, Creighton University Medical Center/CHI Health, 601 North 30th Street, Suite 3704, Omaha, NE 68131, USA
| | - Marinella Gugliotta
- Neurosurgery, Andreas Klinik Cham, CHUV Rue du Bugnon 46, 1011 Lausanne Andreas Klinik Cham Rigistrasse 1, 6330 Cham, Zug, Switzerland
| | - John Michael Duff
- Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (Unil), Lausanne, Switzerland
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Recurrent solitary fibrous tumor of lumbar spine with vertebral body involvement: imaging features and differential diagnosis with report of a case. Radiol Case Rep 2016; 11:450-455. [PMID: 27920879 PMCID: PMC5128393 DOI: 10.1016/j.radcr.2016.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/16/2016] [Accepted: 08/21/2016] [Indexed: 11/21/2022] Open
Abstract
Solitary fibrous tumors (SFTs) of the spine are exceedingly rare tumors of mesenchymal origin. Most spinal SFTs arise from the thoracic spine, followed by cervical spine, and last lumbar spine with only 6 cases reported in literature. SFTs represent a wide range of neoplasms, ranging from benign to malignant. These tumors can develop a late recurrence, even after a decade or more of initial presentation, requiring long-term follow-up. We present a case of recurrent SFT of the lumbar spine with vertebral body involvement, presenting more than a decade after initial resection. It was initially misdiagnosed as a paraganglioma. To the best of our knowledge, there have been only 3 previous cases reporting SFT with vertebral body involvement.
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Hwang US, Kim SB, Jo DJ, Kim SM. Intramedullary solitary fibrous tumor of cervicothoracic spinal cord. J Korean Neurosurg Soc 2014; 56:265-8. [PMID: 25368773 PMCID: PMC4217067 DOI: 10.3340/jkns.2014.56.3.265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/13/2014] [Accepted: 09/06/2014] [Indexed: 11/27/2022] Open
Abstract
Solitary fibrous tumor is rare benign mesenchymal neoplasm. The spinal solitary fibrous tumor is extremely rare. The authors experienced a case of intramedullary solitary fibrous tumor of cervicothoracic spinal cord in a 48-year-old man with right lower extremity sensory disturbance. Spinal MRI showed intradural mass lesion in the level of C7-T1, the margin between the spinal cord and tumor was not clear on MRI. A Left unilateral laminectomy and mass removal was performed. Intra operative finding, the tumor boundary was unclear from spinal cord and it had intramedullary and extramedullary portion. After surgery, patient had good recovery and had uneventful prognosis. Follow up spinal MRI showed no recurrence of tumor.
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Affiliation(s)
- Ui Seung Hwang
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung Bum Kim
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dae Jean Jo
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung Min Kim
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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Tomek M, Bravi I, Mendoza N, Alsafi A, Mehta A, Molinaro L, Singh P, Radotra B, Dei Tos AP, Roncaroli F. Spinal extradural solitary fibrous tumor with retiform and papillary features. Ann Diagn Pathol 2013; 17:281-7. [DOI: 10.1016/j.anndiagpath.2013.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 01/12/2013] [Accepted: 01/13/2013] [Indexed: 10/27/2022]
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Williams R, Foote M, Deverall H. Strategy in the surgical treatment of primary spinal tumors. Global Spine J 2012; 2:249-66. [PMID: 24353976 PMCID: PMC3864485 DOI: 10.1055/s-0032-1329886] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 08/04/2012] [Indexed: 11/18/2022] Open
Abstract
Primary spine tumors are rare, accounting for only 4% of all tumors of the spine. A minority of the more common primary benign lesions will require surgical treatment, and most amenable malignant lesions will proceed to attempted resection. The rarity of malignant primary lesions has resulted in a paucity of historical data regarding optimal surgical and adjuvant treatment and, although we now derive benefit from standardized guidelines of overall care, management of each neoplasm often proceeds on a case-by-case basis, taking into account the individual characteristics of patient operability, tumor resectability, and biological potential. This article aims to provide an overview of diagnostic techniques, staging algorithms and the authors' experience of surgical treatment alternatives that have been employed in the care of selected benign and malignant lesions. Although broadly a review of contemporary management, it is hoped that the case illustrations given will serve as additional "arrows in the quiver" of the treating surgeon.
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Affiliation(s)
- Richard Williams
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,Address for correspondence and reprint requests Richard Williams Institute of Health and Biomedical Innovation, Queensland University of Technology8/259 Wickham Tce, Brisbane 4000, QueenslandAustralia
| | - Matthew Foote
- Department of Radiation Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
| | - Hamish Deverall
- Department of Orthopaedics, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
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Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996-July 2011). Adv Anat Pathol 2011; 18:356-92. [PMID: 21841406 DOI: 10.1097/pap.0b013e318229c004] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We reviewed the world literature on solitary fibrous tumors of the central nervous system from August 1996 to July 2011, focusing on both clinicopathological features and diagnostic findings. The anatomical distribution of the 220 cases reported so far reveals that most are intracranial and just over one-fifth are intraspinal. In decreasing frequency, intracranial tumors involve the supratentorial and infratentorial compartments, the pontocerebellar angle, the sellar and parasellar regions, and the cranial nerves. Intraspinal tumors are mainly located in the thoracic and cervical segments. Although most solitary fibrous tumors of the central nervous system are dural based, a small subset presents as subpial, intraparenchymal, intraventricular, or as tumors involving the nerve rootlets with no dural connection. Preoperative imaging and intraoperative findings suggest meningioma, schwannoma or neurofibroma, hemangiopericytoma, or pituitary tumors. Immunohistochemistry is critical to establish a definitive histopathological diagnosis. Vimentin, CD34, BCL2, and CD99 are the most consistently positive markers. The usual histologic type generally behaves in a benign manner if complete removal is achieved. Recurrence is anticipated when resection is subtotal or when the tumor exhibits atypical histology. The proliferative index as assessed by MIB1 labeling is of prognostic significance. Occasionally, tumors featuring conventional morphology may recur, perhaps because of minimal residual disease left behind during surgical extirpation. Rare extracranial metastases and tumor-related deaths are on record. Surgery is the treatment of choice. Stereotactic and external beam radiation therapy may be indicated for postsurgical tumor remnants and for unresectable recurrences. Long-term active surveillance of the patients is mandatory.
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Fargen KM, Opalach KJ, Wakefield D, Jacob RP, Yachnis AT, Lister JR. The central nervous system solitary fibrous tumor: a review of clinical, imaging and pathologic findings among all reported cases from 1996 to 2010. Clin Neurol Neurosurg 2011; 113:703-10. [PMID: 21872387 DOI: 10.1016/j.clineuro.2011.07.024] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 02/08/2011] [Accepted: 07/27/2011] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Central nervous system (CNS) solitary fibrous tumor (SFT) is a rare lesion first identified as a unique entity in 1996. We describe two cases treated at the University of Florida followed by a review of all reported cases of CNS SFT between 1996 and 2010. METHODS A review of the literature was performed to identify all reported cases of CNS SFT. RESULTS 189 cases (including the two presented herein) were discovered, of which 46 were spinal and 143 were intracranial. Demographic, imaging, and pathologic findings are presented. Roughly 6% of reported lesions are malignant. Subtotal resection (STR) was associated with a 16-fold increased odds of recurrence (OR 15.9, 95% CI 5.5-46.1), although mean follow-up was shorter in those cases of GTR without recurrence. CONCLUSION CNS SFT is a rare lesion. Six percent of lesions are malignant. GTR is superior to STR although the degree of superiority is not clear.
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Affiliation(s)
- Kyle M Fargen
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA.
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Takenouchi T, Pannullo SC, Stieg PE, Lavi E. Solitary Fibrous Tumor With Multiple Intracranial and Spinal Lesions: Case Report. Neurosurgery 2011; 68:E1148-51; discussion E1151. [DOI: 10.1227/neu.0b013e31820a1573] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AbstractBACKGROUND AND IMPORTANCE:Solitary fibrous tumor (SFT) has been previously reported for its wide variety of presentations and atypical sites. We report a case of recurrent SFT with multiple intracranial and spinal lesions.CLINICAL PRESENTATION:A 45-year-old female with recurrent right frontoparietal SFT was found to have multiple intracranial and spinal lesions. Most of the lesions are asymptomatic. Each of the intracranial and spinal lesions has been confirmed histologically. In 1999 the patient was found to have a single right temporal SFT and had a gross total resection of the lesion. In 2005 the patient underwent a second gross total resection for the recurrence of the right temporal-parietal lesion, followed by radiation therapy. In 2009 she underwent a third and fourth gross total resection of the right frontoparietal lesion, and the L4-5 mass, as well as a cervical laminectomy for an extramedullary spinal lesion causing spinal compression.CONCLUSION:This is the first case report of recurrent SFT with multiple intracranial and spinal lesions. This case illustrates the nature of recurrence and multiplicity of SFT and raises the importance of a thorough investigation, especially in the entire neuroaxis, in patients with the diagnosis of SFT. This case also questions the justification of the name that was given to this tumor.
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Affiliation(s)
- Toshiki Takenouchi
- Department of Pediatrics, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Susan C. Pannullo
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Philip E. Stieg
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Ehud Lavi
- Department of Pathology and Laboratory Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
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