Intracranial anaplastic solitary fibrous tumor/hemangiopericytoma: immunohistochemical markers for definitive diagnosis

Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Series of 14 Cases and Review of the Literature

Solitary fibrous tumor (SFT) is a rare type of tumor characterized by spindle-shaped cells originating from mesenchymal tissue. This case series presents a collection of 14 intracranial solitary fibrous tumors treated between 2014 and 2022 in our institute in Bucharest, Romania. Through a systematic investigation, key aspects spanning the preoperative, intraoperative, and postoperative phases of patient care were highlighted. Our study examines various factors including tumor location (which was very heterogeneous), size (median of 49 mm, ranging between 22 mm and 70 mm), surgical techniques employed, and recurrence rates. The data was analyzed using Python version 3.10 (Python Software Foundation, Wilmington, Delaware, United States). Gender disparities in SFT were noted, particularly the male-to-female ratio which was 5:9. The use of the Medical Research Council (MRC) Scale for Muscle Strength aided in evaluating severity and postoperative outcomes. GTR was achieved in nine out of 14 cases (64.28%), prolonging the period of recurrence-free survival.

Complete loss of E-cadherin expression in a rare case of metastatic malignant meningioma: a case report

BACKGROUND

Hematogenous tumor spread of malignant meningiomas occurs very rarely but is associated with very poor prognosis.

CASE PRESENTATION

We report an unusual case of a patient with a malignant meningioma who developed multiple metastases in bones, lungs and liver after initial complete resection of the primary tumor. After partial hepatic resection, specimens were histologically analyzed, and a complete loss of E-cadherin adhesion molecules was found. No oncogenic target mutations were found. The patient received a combination of conventional radiotherapy and peptide receptor radionuclide therapy (PRRT). Due to aggressive tumor behavior and rapid spread of metastases, the patient deceased after initiation of treatment.

CONCLUSIONS

E-cadherin downregulation is associated with a higher probability of tumor invasion and distant metastasis formation in malignant meningioma. Up to now, the efficacy of systemic therapy, including PRRT, is very limited in malignant meningioma patients.

Solitary fibrous tumor of the central nervous system invading and penetrating the skull: A case report

Solitary fibrous tumor (SFT) of the central nervous system is a rare spindle cell tumor of mesenchymal origin. The present study reports the case of a 44-year-old male patient with SFT. Magnetic resonance imaging demonstrated that the majority of the intracranial tumors exhibited uneven low signals on T1-weighted imaging (T1WI) and low mixed signals on T2WI, and there was an enhancement on enhanced scanning. Furthermore, the distal part of the left occipital lobe exhibited hypersignals on T1WI and T2WI, and this was significantly enhanced following enhanced scanning. The lower part of the scalp exhibited low signals on T1WI and high signals on T2WI, and there was no notable enhancement following enhanced scanning. Magnetic resonance spectroscopy demonstrated an elevated choline/creatine peak in the solid part of the tumor. Under the microscope, the tumor exhibited characteristic 'staghorn-shaped' blood vessels. As SFT is difficult to differentially diagnose via imaging, immunohistochemical analysis of CD34, vimentin and signal transducer and activator of transcription 6 was performed for the definitive diagnosis of SFT. Of note, surgical resection was the preferred treatment for SFT; however, due to the rarity of the tumor, subsequent adjuvant therapy and prognosis require further investigation.

Primary Intracranial Solitary Fibrous Tumor With Metachronous Pulmonary and Bone Metastasis: A Case Report

An intracranial solitary fibrous tumor (SFT) is a rare and aggressive tumor with a high propensity for locoregional recurrence and distant metastasis. The formerly used collective term for this tumor, "solitary fibrous tumor/hemangiopericytoma", has recently fallen out of use and is now commonly replaced with the term "solitary fibrous tumor". We describe a rare case of intracranial SFT with simultaneous metastasis to the spine, the right humerus, and the lungs four years after resection and radiotherapy of the primary tumor.

Solitary fibrous tumors in prostate: a case report with review of the literature

BACKGROUND

Solitary fibrous tumor (SFT) is a relatively rare type of mesenchymal neoplasm that occurs most frequently in the pleura. However, SFT originating from the prostate is particularly uncommon and only approximately 39 cases were reported before. Herein, we reported a rare case of a patient diagnosed with prostate SFT and presented a literature review.Case presentation: A 50-year-old Asian with irritative urinary symptoms was admitted to our hospital and almost all the evidence indicated that benign prostate hyperplasia (BPH) caused his symptoms. Therefore, transurethral resection of the prostate (TURP) was performed, but histopathological and Immunohistochemical (IHC) assessments showed that spindle cells arranged disorderly in the TURP specimen with a cluster of differentiation 34 (CD34), B-cell lymphoma-2 (Bcl-2), and signal transducer and activator of transcription 6 (STAT6) highly expressed and SFT was diagnosed. Finally, the patient underwent a radical prostatectomy and there was no disease progression observed thereafter.

CONCLUSIONS

Prostate SFT is extremely rare, and to our knowledge, this is the first case of prostate SFT that is difficult to differentiate from small volume BPH. IHC examinations are of great diagnostic value. Radical resection of the tumor appears to be the most effective method at present and continuous follow-up is highly recommended.

Transcriptome and proteomics conjoint analysis reveal metastasis inhibitory effect of 6-shogaol as ferroptosis activator through the PI3K/AKT pathway in human endometrial carcinoma in vitro and in vivo

Endometrial cancer remains as one of the widespread female malignancies despite the existing treatment measures mainly surgery, radiotherapy, and chemotherapy. In recent times, studies have focused on medicinal plants such as ginger due to its multifaceted characteristics compared to conventional medicine. 6-Shogaol is regarded as the main active compound of ginger participating in pharmacological activities and combating various health disorders, especially cancer. In our study, we compared the effects of 6-gingerol, 6-paradol, and 6-shogaol on Ishikawa cells, and found 6-shogaol as a more effective ingredient against Ishikawa cell proliferation. Moreover, its promoted ferroptosis, as a result, triggered mitochondrial morphologic alternation, as well as changed iron concentration, GSH and MDA levels. Furthermore, 6-Shogaol inhibited cell metastasis by influencing cell invasion and migration. Finally, 6-shogaol could trigger PI3K/AKT signaling pathways in vitro and in vivo confirmed by western blotting assay and immunohistochemical evaluation. These findings suggest that 6-shogaol can be used as promising functional food component in health diet and in drug target methods for endometrial cancer therapy.

Solitary Fibrous Tumor of the Paranasal Sinuses with Intracranial Extension: A Rare Case Report and Review of the Literature

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that were initially identified in the pleura. SFTs in the nasal or paranasal sinuses are especially rare. Most SFTs exhibit indolent behavior, with a low local recurrence rate. A 39-year-old man complained of bilateral nasal congestion, hyposmia, and occasional right eye tears six months prior to hospitalization. Based on MRI and CT imaging, a total gross surgical resection was achieved. Subsequently, postsurgical histopathological examinations were conducted. Under the microscope, pathological mitotic bodies were visible (<5 mitoses per 2 mm2). The immunohistochemical staining results revealed that tumor cells were positive for CD34, BCL-2, STAT-6, and Ki-67 (<5%) but negative for EMA, S-100, PR, GFAP, and SMA. Based on these findings, the patient was diagnosed with SFT.

Grade III solitary fibrous tumor/hemangiopericytoma: An enthralling intracranial tumor—A case report and literature review

Hemangiopericytomas account for less than 1% of all intracranial tumors. In 2016, World Health Organization (WHO) unified the two terms into a single medical condition known as solitary fibrous tumor/hemangiopericytoma (SFT/HPC). Our patient is an 80-year-old woman with a past medical history of sick sinus syndrome status post pacemaker placement. She presented to the emergency department with progressive headaches for one month duration. Her headaches worsened at night, waking her up from sleep. They also increased in intensity by bending forward. Review of systems was significant for bilateral lower extremity weakness accompanied by difficulty walking. The motor exam was remarkable for right upper and right lower extremity 3/5 weakness. The gait was ataxic. A Computed tomography scan of the head without contrast revealed a large dural-based right parietal hyperdense mass with surrounding edema, mass effect, and compression of the right lateral ventricle atrium. A right-to-left midline shift was also noted. Given the fact that our patient had a pacemaker, she was not a candidate for a brain MRI. Neurosurgery successfully resected the mass. Histopathological studies confirmed WHO grade III anaplastic solitary fibrous tumor/hemangiopericytoma. The patient was discharged on adjuvant radiation with imaging surveillance given the grade and the extent of resection. This case highlights a rare type of intracranial mass that resembles meningioma on imaging studies. It also illustrates that solitary fibrous tumor/hemangiopericytoma should be kept as a differential diagnosis for brain masses, given its aggressive nature, and its potential of metastasis and recurrence.

Delayed pulmonary metastasis and recurrence of intracranial malignant solitary fibrous tumor/hemangiopericytoma: Case report and literature review

Solitary fibrous tumors/hemangiopericytomas (SFTs/HPCs) are intracranial spindle cell tumors that originate from interstitial tissue. SFTs/HPCs that are primary malignant intracranial tumors are exceedingly uncommon. A case of intracranial malignant SFT/HPC that originated intracranially and spread to the pulmonary region is described herein. Furthermore, the specimens from two surgical resections obtained when the patient had undergone two prior procedures for intracranial ‘meningiomas’ were also reviewed. The results of the lung biopsy matched the morphologic appearance of the intracranial tumor. The patient died ~2 years after the chest pain started. In addition, the literature was reviewed. According to previous studies, STAT6 expression was positive in 100% of SFTs/HPCs and radiologic characteristics assisted in determining the tumor pathology and grade. Surgical management has been the mainstay treatment for SFTs. In cases of incomplete resection, adjuvant radiotherapy is effective and rigorous follow-up is required to monitor for recurrence.

Clinical Features, Management, and Prognostic Factors of Intracranial Solitary Fibrous Tumor

Background

Because of the low incidence and the constantly changing diagnostic and classification criteria, the clinical features, management, and prognostic factors of intracranial solitary fibrous tumor (ISFT) remain unclear and were thus analyzed in this study.

Method

A total of 38 patients with ISFTs who were diagnosed in our institution were enrolled in this study. Patient data including age, gender, clinical presentation, histopathological features, immunohistochemistry staining, tumor location, tumor size, treatment methods, and prognosis were extracted and retrospectively analyzed.

Results

The median age at diagnosis was 45.5 years (range 28–66 years) and the male-to-female ratio was 1:1.53 in our series. The 3-, 5-, and 10-year progression-free survival (PFS) rate was 82.2%, 62.8%, and 21.4%, respectively; and the 3-, 5-, and 10-year overall survival rate was 97.1%, 86.9%, and 64.2%, respectively. Patients with high WHO grade (grade 3) ISFTs experienced impaired PFS (p < 0.05) and OS (p < 0.01). Subtotal resection (STR) was associated with worse PFS and OS (p < 0.001, respectively). Postoperative radiotherapy (PORT) improved PFS, especially local control rate, in patients with WHO grade 3 ISFTs (P = 0.025) or STR (p = 0.027). Moreover, CD34-negative immunostaining and a high Ki-67 index (>10%) were associated with impaired PFS in ISFTs.

Conclusion

Our study provides evidence that high tumor grade, subtotal tumor resection, CD34 negative immunostaining, and high Ki-67 index (>10%) were independent predictors for the poor prognosis of ISFTs. PORT can improve local control rate, and should be recommended for patients with high-grade ISFTs or STR.

Intracranial Primary Malignant Solitary Fibrous Tumor/Hemangiopericytoma Masquerading as Meningioma: Report of a Rare Case

Background

Intracranial solitary fibrous tumors/hemangiopericytomas (SFTs/HPCs) are rare spindle cell tumors originating from interstitial tissue that are usually benign. Primary malignant intracranial SFTs/HPCs are extremely rare. Here we describe a case of malignant intracranial SFT/HPC.

Case Presentation

A 59-year-old woman presented with a space-occupying lesion in the left cerebellar tentorium. Based on imaging findings, we made a preoperative diagnosis of meningioma. During the operation, we found that the tumor had an abnormally rich blood supply and could not be completely removed. Histologic findings, immunophenotype (positive for cluster of differentiation [CD]34, CD99, signal transducer and activator of transcription 6, and B cell lymphoma 2), and a Ki-67 proliferative index of 20–30% for the primary tumor were typical of malignant intracranial SFT/HPC. The tumors showed high sensitivity to radiotherapy and the residual tumor was significantly reduced after intensity-modulated radiation therapy. The patient has had no neurologic symptoms and no recurrence of the tumor in 2 years of follow-up.

Conclusion

Intracranial SFTs/HPCs are extremely rare. Radiologic examination before the operation is helpful for making a definite diagnosis and judging tumor grade; STAT6 immunohistochemistry is a sensitive alternative diagnostic method. Adjuvant radiotherapy is effective in cases of incomplete resection, and strict follow-up is essential in order to monitor for possible recurrence.