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Chenhui Z, He G, Wu Z, Rong J, Ma F, Wang Z, Fang J, Gao W, Song H, Zhang F, Di G, Jiang X. Intracranial solitary fibrous tumor/hemangiopericytomas: a clinical analysis of a series of 17 patients. Br J Neurosurg 2024; 38:617-624. [PMID: 34334066 DOI: 10.1080/02688697.2021.1944980] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/21/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Solitary fibrous tumors (SFTs) and haemangiopericytomas (HPCs) are rare mesenchymal tumors in central nervous system (CNS). Although progressed recognition to the diagnosis and treatment of SFT/HPCs, it still remains many confusions regarding on its occurrence, aggressive evolution, malignant transformation, dedifferentiation phenomenon, distant metastasis and unpredictable propensity. PATIENTS AND METHODS Seventeen cases of CNS SFT/HPCs who underwent surgical treatment from January 2010 to December 2020 were collected in the authors' institute. Clinical, radiological, pathological data and followup details were reviewed in all cases. RESULTS The age of this series was 41-73 years old. Seven cases located subtentorially, five cases originated from middle skull base and four in supratentorial. MRI shows iso-signal intensity on T1WI, and heterogeneous slightly long/short signal on T2WI. There is significant contrast after gadolinium-enhancement. It is easy to be misdiagnosed before surgery. The positive rate of nuclear STAT6 is 94.12%, higher than CD34 (87.5%). Eight patients were grade I, eight grade II and one in grade III. Five cases developed tumor relapse, in which two cases had local intracranial recurrence combined with dissemination and metastasis of cerebrospinal fluid in the spinal canal, accompanied by pathological malignant transformation, and another one occurred blood metastasis. CONCLUSIONS CNS SFT/HPCs are rare intracranial tumors with unpredictable propensity. Gross total resection is critical to its overall clinical prognosis. Given its potential recurrence and malignant transition, adjuvant radiotherapies are recommended when necessary, and long-term follow-up is indispensable. The underlying molecular biological mechanisms are still needed to be further exploration.
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Affiliation(s)
- Zhao Chenhui
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guoyuan He
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zeyu Wu
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jun Rong
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Fengchun Ma
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zhichun Wang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jincheng Fang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wanwan Gao
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Hong Song
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Fan Zhang
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Guangfu Di
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Xiaochun Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Piscopo AJ, Chowdhury AJ, Teferi N, Lee S, Challa M, Petronek M, Eschbacher K, Bathla G, Buatti JM, Hitchon P. Surgical Management of Craniospinal Axis Solitary Fibrous Tumors: A Single-Institution Case Series and Comprehensive Review of the Literature. Neurosurgery 2024; 94:358-368. [PMID: 37747216 DOI: 10.1227/neu.0000000000002692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Meningeal solitary fibrous tumors (SFTs) comprise 0.4% of primary central nervous system neoplasms and carry metastatic potential. Disease course and optimal management are largely unknown, and there is currently no literature rigorously describing neurological outcomes in surgically managed SFTs. We present one of the largest craniospinal SFT series, analyze patient outcomes, and extensively review the associated literature. METHODS All surgically managed SFTs at our institution between January 2005 and March 2023 were retrospectively reviewed. Patient demographics, tumor and radiographic features, treatment, and clinical outcomes were collected. Neurological function was quantified using Frankel grade and Neurologic Assessment in Neuro-Oncology scores. Descriptive statistics, multivariate analysis, log-rank test, and Kaplan-Meier survival analysis were performed. RESULTS Twenty-one patients satisfied inclusion criteria. Tumor locations included 15 supratentorial, three infratentorial, and three spinal. All patients underwent surgical resection, and 16 (76.2%) underwent radiation. Six (28.6%) patients had tumor recurrence, and three (14.3%) developed metastasis. Younger age and higher postoperative Frankel grade were significantly associated with increased overall survival (OS) ( P = .011, P = .002, respectively). All patients symptomatically improved or stabilized after surgery, and Neurologic Assessment in Neuro-Oncology score ( P = .001) and functional status significantly improved postoperatively (Karnofsky Performance Status: 65.2 ± 25.2 vs 91.4 ± 13.5, P = .001). Sex, adjuvant radiation, and extent of resection were not significantly associated with OS. CONCLUSION SFT of the central nervous system is a rare entity with a variable clinical course. Surgical resection was associated with improved postoperative functional and neurological status. Higher postoperative neurological function was significantly associated with OS. Further studies are warranted to validate a standardized treatment algorithm and investigate the efficacy of adjuvant radiation in SFT.
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Affiliation(s)
- Anthony J Piscopo
- Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - A J Chowdhury
- Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Nahom Teferi
- Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Sarah Lee
- Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Meron Challa
- University of Iowa, Carver College of Medicine, Iowa City , Iowa , USA
| | - Michael Petronek
- Department of Radiation Oncology, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Kathryn Eschbacher
- Department of Pathology, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Girish Bathla
- Department of Radiology, Mayo Clinic, Rochester , Minnesota , USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
| | - Patrick Hitchon
- Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City , Iowa , USA
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3
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de Paiva JLR, Sabino JV, Pereira FV, Okuda PA, Villarinho LDL, Queiroz LDS, França MC, Reis F. The Role of MRI in the Diagnosis of Spinal Cord Tumors. Semin Ultrasound CT MR 2023; 44:436-451. [PMID: 37555685 DOI: 10.1053/j.sult.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Spinal cord tumors are uncommon, and its multiple representatives not always have pathognomonic characteristics, which poses a challenge for both patients and caring physicians. The radiologist performs an important role in recognizing these tumors, as well as in differentiating between neoplastic and non-neoplastic processes, supporting clinical and surgical decision-making in patients with spinal cord injury. Magnetic Resonance Imaging (MRI) assessment, paired with a deep understanding of the various patterns of cord involvement allied to detailed clinical data can provide a diagnosis or significantly limit the differential diagnosis in most cases. In this article, we aim to review the most common and noteworthy intramedullary and extramedullary spinal tumors, as well as some other tumoral mimics, with an emphasis on their MRI morphologic characteristics.
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Affiliation(s)
- Jean L R de Paiva
- Department of Anesthesiology, Oncology and Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - João V Sabino
- Department of Anesthesiology, Oncology and Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fernanda V Pereira
- Department of Anesthesiology, Oncology and Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Paulo A Okuda
- Department of Anesthesiology, Oncology and Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | - Marcondes C França
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fabiano Reis
- Department of Anesthesiology, Oncology and Radiology, University of Campinas (UNICAMP), Campinas, Brazil.
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4
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Arshad MM, Ali A, Thabet A, AI-Bozom IA. Delayed cervical spine metastasis from intracranial solitary fibrous tumor. J Neurosci Rural Pract 2023; 14:750-753. [PMID: 38059253 PMCID: PMC10696358 DOI: 10.25259/jnrp_252_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/25/2023] [Indexed: 12/08/2023] Open
Abstract
Cervical spine metastasis from primary intracranial solitary fibrous tumors (SFTs) is an extremely rare clinical entity. This report focuses on its metastatic tendency, radiological imaging, management plan, and follow-up strategies in view of its long latency period for metastasis. A 35-year-old female presented with right-side cervical radiculopathy. Magnetic resonance imaging spine showed C7 vertebral body collapse with retropulsion and neural compression. Two years ago, the patient had surgical resection of intracranial SFT (World Health Organization grade 3) with no evidence of recurrence on follow-up imaging. Cervical C7 metastasis has been decompressed and fused by the anterior cervical approach. Histopathology confirmed SFT metastasis to the spine, and the patient received adjuvant radiotherapy. Cervical metastasis from well-controlled primary intracranial SFT poses a significant challenge for its diagnostic and management planning. Serial pre-emptive surveillance is warranted with regular imaging and appropriate patient counseling.
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Affiliation(s)
- Mohammad Mohsin Arshad
- Department of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Arshad Ali
- Department of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Abdulnasser Thabet
- Department of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
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Lin Q, Zhu J, Zhang X. Solitary fibrous tumor of the central nervous system invading and penetrating the skull: A case report. Oncol Lett 2023; 25:81. [PMID: 36742362 PMCID: PMC9853498 DOI: 10.3892/ol.2023.13667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
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.
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Affiliation(s)
- Qiyan Lin
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China
| | - Jiabin Zhu
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China
| | - Xiaofeng Zhang
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China,Correspondence to: Professor Xiaofeng Zhang, Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, 65 Jucheng Avenue, Zhongshan, Guangdong 528415, P.R. China, E-mail:
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6
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Jeong J, Jin SY. Extrapleural Malignant Solitary Fibrous Tumor Presenting as Invasive Bilateral Paravertebral Tumors: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:304-310. [PMID: 36818699 PMCID: PMC9935967 DOI: 10.3348/jksr.2022.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/03/2022] [Accepted: 06/18/2022] [Indexed: 02/10/2023]
Abstract
Solitary fibrous tumors (SFTs) commonly arise from the pleura and are mostly benign. However, they may develop anywhere in the body, and 10%-30% are malignant. Classically, SFTs appear as solitary enhancing masses, and bilateral presentation is extremely rare. In this case, an 88-year-old male presented with back pain and a history of chronic tuberculous empyema. Imaging studies revealed bilateral paravertebral masses with aggressive radiologic features, which were speculatively presumed as thoracic malignancies in association with chronic empyema. Herein, we report a unique case of bilateral paravertebral malignant SFTs that were accurately diagnosed with a CT-guided coaxial needle biopsy.
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Affiliation(s)
- Jewon Jeong
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - So-Young Jin
- Department of Pathology, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Thapa S, Yamahata H, Okada T, Yonenaga M, Bajagain M, Makino R, Hanaya R. Spinal intradural solitary fibrous tumor/ hemangiopericytoma with intramedullary invasion mimicking a hemangioblastoma. Surg Neurol Int 2022; 13:443. [PMID: 36324920 PMCID: PMC9610592 DOI: 10.25259/sni_655_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/29/2022] [Indexed: 11/14/2022] Open
Abstract
Background: Solitary fibrous tumor/hemangiopericytomas (SFT/HPCs) are rare mesenchymal tumors of nonmeningothelial origin that comprises <1% of all central nervous system tumors. Case Description: A 45-year-old male presented with sleep apnea (apnea-hypopnea index was 17.1 events/hour) and dysesthesias of the right upper and lower extremities. The magnetic resonance demonstrated a heterogeneous intradural extra-axial C1 mass with syringobulbia and syringomyelia. The right vertebral angiography revealed a hypervascular mass (i.e., intense tumor staining). With the preoperative diagnosis of a spinal hemangioblastoma, the patient underwent tumor removal. However, intraoperative findings demonstrated that the ventral component of the tumor was intramedullary without a dural attachment. Further, the histological diagnosis was consistent with SFT/HPC (HPC phenotype). The postoperative course was uneventful, and the patient’s symptoms and the syrinxes spontaneously regressed. Conclusion: A 45-year-old male presented a rare spinal intradural lesion at C1 appeared to be a spinal hemangioblastoma, but proved to be SFT/HPC (HPC phenotype) with intramedullary invasion.
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8
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De Jesus O, Carballo Cuello CM, Fernández-de Thomas RJ, Pastrana EA. Gamma Knife radiosurgery for a recurrent craniocervical junction solitary fibrous tumour. BMJ Case Rep 2022; 15:e250566. [PMID: 36113959 PMCID: PMC9486226 DOI: 10.1136/bcr-2022-250566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Spinal solitary fibrous tumour (SFT) is an uncommon tumour with few cases reported in the literature. It rarely originates at the craniocervical junction. To our knowledge, only eight cases of spinal SFT located at the craniocervical junction have been reported in the literature. We presented a patient with a craniocervical junction SFT and discussed its clinical presentation, radiological features, pathology, management and outcome. This was the first patient reported in the literature with a recurrent craniocervical junction SFT treated with Gamma Knife radiosurgery. The treatment reduced the tumour volume by more than 85% within 12 months.
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Affiliation(s)
- Orlando De Jesus
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | - Emil A Pastrana
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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9
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Solitary Fibrous Tumor of the Spine: Imaging Grading Diagnosis and Prognosis. J Comput Assist Tomogr 2022; 46:638-644. [PMID: 35405722 DOI: 10.1097/rct.0000000000001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the imaging features and prognosis of spinal solitary fibrous tumors (SFTs) of different pathological grades. METHODS The clinical features, computed tomography and magnetic resonance (MR) images, and follow-up data of 23 patients with SFTs were reviewed. The patients were divided into 3 groups according to their pathological manifestations: grade 1 (n = 3), grade 2 (n = 14), and grade 3 (n = 6). The following imaging features were recorded: location, computed tomography density/MR intensity, enhancement pattern, dural tail sign, adjacent bone remodeling, lobulation, and tumor size. The immunohistochemical (Ki-67/MIB-1) levels were also investigated. All parameters were statistically analyzed between grade 2 and 3 tumors. RESULTS The Ki-67/MIB-1 index was markedly higher in grade 3 tumors than in grade 2 tumors (P < 0.001). All grade 1 lesions appeared hypointense on T2-weighted image, whereas grade 2 and 3 lesions appeared isointense or mildly hyperintense. There were significant differences in enhancement type and osteolytic bony destruction between grade 2 and 3 tumors (P < 0.05). However, no marked differences were found in the distribution of age, sex, location, MR signal, degree of enhancement, compressive bony absorption, dural tail sign, or maximum vertical/traverse diameter ratio. Malignant progression occurred less frequently in patients with grade 2 tumors than in those with grade 3 tumors, but the difference was not statistically significant. CONCLUSIONS Different grades of spinal SFTs have different degrees of proliferation and imaging features, especially grade 3 tumors, which show a heterogeneous enhancement pattern, osteolytic bony destruction, and a higher possibility of recurrence and metastasis.
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10
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Wang L, Yu J, Shu D, Huang B, Wang Y, Zhang L. Primary endodermal hemangiopericytoma/solitary fibrous tumor of the cervical spine: a case report and literature review. BMC Surg 2021; 21:405. [PMID: 34837986 PMCID: PMC8626743 DOI: 10.1186/s12893-021-01399-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 11/07/2021] [Indexed: 12/18/2022] Open
Abstract
Background Hemangiopericytoma (HPC), also known as solitary fibrous tumor (SFT), is a type of soft tissue sarcoma with a special aggressive behavior. The HPC/SFT is locally aggressive with possibility of late recurrence locally or distant extraneural metastasis. The most common location of this HPC/SFT is the lower extremities. The HPC/SFT in the central nervous system (CNS) is very rare, and compared with the brain, it is rarer in the spinal region. However, clinicians also lack an overall understanding of the diagnosis of HPC/SFT in the spinal cord. Case presentation In this study, we report a rare case of primary cervical spine HPC/SFT in a 53-year-old woman. Two to three weeks before admission, she experienced pain and numbness in her left upper extremity. After computerized tomography (CT) and magnetic resonance imaging (MRI), a gross total resection was performed. Obvious neurological improvement was observed postoperatively. The pain and numbness in the patient's left upper limb were relieved subsequently. We then reviewed the literature on HPC/SFT, such as its clinical presentation, imaging characteristics, treatment, and follow-up. Conclusions Diagnosis of HPC/SFT relies on magnetic resonance spectroscopy, enhanced CT, and MRI. Postoperative radiotherapy is strongly recommended to reduce the HPC/SFT recurrence. Immunohistochemical analysis can also help in the differential diagnosis. However; early and long-term follow-up is necessary for patients.
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Affiliation(s)
- Liyun Wang
- Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Jianbo Yu
- Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dongping Shu
- Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Bin Huang
- Department of Neurosurgery, Xinchang Hospital of Traditional Chinese Medicine, Shaoxing, China
| | - Yumin Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
| | - Luyuan Zhang
- Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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11
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Olmsted ZT, Tabor J, Doron O, Hosseini H, Schneider D, Green R, Wahl SJ, Sciubba DM, D'Amico RS. Intradural Extramedullary Solitary Fibrous Tumor of the Thoracic Spinal Cord. Cureus 2021; 13:e18613. [PMID: 34765368 PMCID: PMC8572645 DOI: 10.7759/cureus.18613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 01/04/2023] Open
Abstract
Solitary fibrous tumors (SFTs) are rare soft tissue neoplasms that can impact the central nervous system (CNS). SFTs comprise <1% of all primary CNS tumors. Here, we describe a rare case of intradural, extramedullary SFT arising within the thoracic spine that was treated with surgical resection. Histological features were evaluated and revealed a highly cellular tumor with positive expression of BCL2, CD34, CD99, and STAT6 proteins that are consistent with a diagnosis of SFT. We discuss the use of surgical intervention for long-term disease control of spinal SFT and evaluate the role of postoperative radiation therapy in management strategies. Lastly, we review the literature reports of intradural, extramedullary SFTs in the thoracic spine. The importance of molecular characterization by histopathology to properly determine diagnosis and prognosis is emphasized.
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Affiliation(s)
| | - Joanna Tabor
- Neurological Surgery, Northwell Health, New York, USA
| | - Omer Doron
- Neurological Surgery, Northwell Health, New York, USA
| | - Hossein Hosseini
- Pathology and Laboratory Medicine, Northwell Health, New York, USA
| | | | - Ross Green
- Neurological Surgery, Lenox Hill Hospital, New York, USA
| | - Samuel J Wahl
- Pathology and Laboratory Medicine, Northwell Health, New York, USA
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Singla R, Singh PK, Khanna G, Suri V, Agarwal D, Chandra PS, Kale SS, Mahapatra AK. An institutional review of 10 cases of spinal hemangiopericytoma/solitary fibrous tumor. Neurol India 2021; 68:448-453. [PMID: 32415022 DOI: 10.4103/0028-3886.284374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Spinal hemangiopericytoma is very rare tumors with only a few case reports and one case series. We have treated ten patients between 2004 and 2017 and, thus, present a retrospective review of our patients with a focus on clinical presentation, radiological features, management, pathology, and outcome. Materials and Methods Histopathological data were reviewed in all the cases and clinical and follow-up details were collected from data available in our department. Results There were five males and five females, including one pediatric patient. The mean age of the patients was 34.7 years (Range 12-52 years). Dorsal, cervical, and lumbar spine involvement were found in five, four, and one patient, respectively. Intradural extramedullary tumor was the most common tumor and all patients presented motor weaknesses. Gross total resection of the tumor was done in seven patients and six patients received postoperative radiotherapy. Histopathology showed anaplastic tumor in two cases with high MIB-1 labelling index. Most patients were positive for CD34, vimentin, mic-2, and bcl-2. While the seven patients who underwent gross total resection improved significantly and were self-ambulatory in the follow-up period, two patients who underwent subtotal resection expired due to tumor metastasis. Conclusion Spinal hemangiopericytoma is a very rare tumor. We present a series of cases treated at our institute for the same. Gross total resection is the goal and radiotherapy should be given in case of residual tumor or high-grade tumors. Prognosis is good after gross total excision and functional recovery can be expected in most patients.
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Affiliation(s)
- Raghav Singla
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Pankaj K Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurav Khanna
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Agarwal
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - P S Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - S S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - A K Mahapatra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Rodríguez-Mena R, Piquer-Belloch J, Llácer-Ortega JL, Riesgo-Suárez P, Rovira-Lillo V, Flor-Goikoetxea-Gamo A, Cremades-Mira A, Mut-Pons R. Cervical intramedullary solitary fibrous tumor: Case report and review of the literature. Surg Neurol Int 2020; 11:468. [PMID: 33500806 PMCID: PMC7827366 DOI: 10.25259/sni_698_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Solitary fibrous tumors (SFTs) are benign tumors derived from mesenchymal tissues that predominantly occur in the pleura. Establishing the diagnosis of these very rare intramedullary spinal lesions, with no clear-cut pathognomonic radiographic characteristics, is particularly challenging. Case Description: Two males, 30 and 41 years of age, presented with progressive cervical myelopathies attributed to a cervical intramedullary exophytic tumor with associated spinal cord edema. One patient showed that the lesion was highly vascularized. Both patients underwent surgical excision of firm, solid, focal, and, particularly in one of them, very vascular/hemorrhagic tumors; at surgery, there was some adherence between the tumors and the cord tissue, but gross-total resections were achieved in both cases, demonstrated on postoperative MR scans. Histological and immunohistochemical findings confirmed the diagnosis of SFT (WHO Grade I). After a 6-month postoperative period, both patients neurologically improved and had no MR evidence of tumor recurrence. Conclusion: Intramedullary cervical exophytic SFTs are extremely rare. Although these solid tumors may present with hemorrhagic features and at surgery demonstrate significant adherence to the pial/cord surface, complete surgical resections are feasible resulting in good outcomes.
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Affiliation(s)
- Ruben Rodríguez-Mena
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - José Piquer-Belloch
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - Jose Luis Llácer-Ortega
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - Pedro Riesgo-Suárez
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - Vicente Rovira-Lillo
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - Alain Flor-Goikoetxea-Gamo
- Department of Neurosurgery, Hospital Universitario de la Ribera, Cátedra de Neurociencias - Fundación Vithas - CEU, Spain
| | - Antonio Cremades-Mira
- Department of Pathology, Hospital Universitario de la Ribera, Carretera de Corbera, Alzira, Valencia, Spain
| | - Raúl Mut-Pons
- Department of Radiology, Hospital Universitario de la Ribera, Carretera de Corbera, Alzira, Valencia, Spain
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14
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Verla T, Simpson V, Ropper AE. Solitary Fibrous tumor of the lumbar spine mimicking a sequestered disc fragment. Radiol Case Rep 2020; 16:472-475. [PMID: 33363685 PMCID: PMC7753083 DOI: 10.1016/j.radcr.2020.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022] Open
Abstract
Solitary fibrous tumor in the lumbar spine is a rare pathology with non-specific radiographic features, sometimes resulting in misdiagnosis. Our patient was a 41-year old female who presented with low back pain and bilateral leg pain. Initial MRI showed a lesion misdiagnosed for a sequestered disc at the mid L4-5 level, which was subsequently characterized appropriately and treated surgically, with resolution of symptoms. Pathologic diagnosis was most consistent with a solitary fibrous tumor due to STAT 6 and CD 34 reactivity. Long-term follow up is recommended in these patients to monitor tumor recurrence and evidence of metastasis.
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Affiliation(s)
- Terence Verla
- Department of Neurosurgery, Baylor College of Medicine, 7200 Cambridge St, Suite 9A, Houston, TX 77030 USA
| | - Venita Simpson
- Naval Medical Center Portsmouth. 620 John Paul Jones Circle, Portsmouth VA 23707
| | - Alexander E Ropper
- Department of Neurosurgery, Baylor College of Medicine, 7200 Cambridge St, Suite 9A, Houston, TX 77030 USA
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15
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Lugo Millan EG, Hess HW, Carballo-Santiago JC, Velez-Rosario R, Labat EJ. A Rare Case of a Primary Spinal Solitary Fibrous Tumor/Hemangiopericytoma in a 9-Month-Old Patient. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923176. [PMID: 33159031 PMCID: PMC7656086 DOI: 10.12659/ajcr.923176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Solitary fibrous tumors (SFTs)/hemangiopericytomas (HPCs) are mesenchymal tumors commonly found in middle-aged patients, usually localized to thoracic pleurae. Spinal tumor involvement is rarely seen, and its imaging findings are largely inconsistent because of the rarity of these cases. We present a case report of a 9-month-old girl with a rare intraspinal tumor with histologic evidence of SFT/HPC, but no STAT6 nuclear immunoreactivity. CASE REPORT A 9-month-old girl, born at term with good prenatal care, presented to the emergency room with regression of developmental milestones. The patient was in good health until 2 months, when she developed decreased spontaneous leg movements. Physical exam revealed diffuse muscular atrophy, with no deep tendon reflexes, sensation, or spontaneous movements of the lower extremities. Computed tomography and magnetic resonance imaging showed a heterogeneous irregular mass filling the lumbosacral spinal canal, extending through the neural foramina to the prevertebral/perivertebral and presacral regions. The tumor was biopsied and referred to the National Institutes of Health for consultation and the diagnosis of SFT/HPC was confirmed on the basis of its histologic features, despite the fact that the tumor was negative for STAT6 immunoreactivity. CONCLUSIONS Although the tumor histology was consistent with SFT/HPC, it was negative for STAT6 nuclear immunoreactivity, which is unusual and may exclude the diagnosis. To our knowledge, this is the youngest patient to present with a spinal SFT with these features.
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Affiliation(s)
- Edrick G Lugo Millan
- Department of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Hans W Hess
- Department of Medical Science, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Juan Carlos Carballo-Santiago
- Department of Pathology and Laboratory Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Roman Velez-Rosario
- Department of Pathology and Laboratory Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Eduardo J Labat
- Department of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
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16
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Primary intra and extradural solitary fibrous tumor/hemangiopericytoma of thoracic spine with paravertebral intrathoracic spread: Case report and review of the literature. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Giordan E, Marton E, Wennberg AM, Guerriero A, Canova G. A review of solitary fibrous tumor/hemangiopericytoma tumor and a comparison of risk factors for recurrence, metastases, and death among patients with spinal and intracranial tumors. Neurosurg Rev 2020; 44:1299-1312. [PMID: 32556679 DOI: 10.1007/s10143-020-01335-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 12/21/2022]
Abstract
Meningeal solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) had been combined into a single classification until 2016. Recurrence and metastases rates are still understudied, especially for spinal SFT/HPCs. Here, we describe CNS SFT/HPCs and predictors for recurrence, metastases, and death, in spinal and intracranial SFT/HPCs, separately. We collected data from studies with patient-level data available on primary SFT/HPCs from multiple online databases. Clinico-demographic data, surgical outcomes, recurrence, metastases, and death rates were abstracted. We used logistic and Cox regression models to identify predictors for recurrence, metastases, and death for spinal and intracranial SFT/HPCs. Twenty-nine studies (368 patients) were included. Higher histological grade and subtotal resection were associated with recurrence (p values < 0.05), while higher histological grade and recurrence (p values < 0.005) were associated with metastases formation. Time to recurrence (p < 0.005) and metastases (p < 0.001) formation were shorter for spinal SFT/HPCs. Death rates were higher among intracranial SFT/HPC patients (p value = 0.001). Among patients with higher histological grade, rates of metastases formation were different between intracranial and spinal SFT/HPCs. Risk of metastases was higher in the first 5 years from surgery for both intracranial and spinal SFT/HPCs. Meningeal SFT/HPCs patients have high rates of recurrence and metastasis, which occur mostly within the first 5 years after diagnosis. Spinal and intracranial SFT/HPCs show similar behavior, but spinal SFT/HPCs tend to develop metastases and recurrences in a shorter interval of time. Careful follow-up for spinal SFT/HPCs should be considered because spinal cases seem to be slightly more aggressive and require more attention.
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Affiliation(s)
- Enrico Giordan
- Department of Neurosurgery, Aulss 2 Marca Trevigiana, Via Piazzale 1, Treviso, Italy.
| | | | - Alexandra M Wennberg
- Department of Neuroscience, University of Padova and Padova Neuroscience Center, Padova, Italy
| | - Angela Guerriero
- Department of Pathology, Aulss 2 Marca Trevigiana, Treviso, Italy
| | - Giuseppe Canova
- Department of Neurosurgery, Aulss 2 Marca Trevigiana, Via Piazzale 1, Treviso, Italy
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18
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Dark as night: Spelunking for spinal solitary fibrous tumors/hemangiopericytomas in the differential of T2 hypointensity. J Clin Neurosci 2020; 78:128-134. [PMID: 32507710 DOI: 10.1016/j.jocn.2020.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/04/2020] [Indexed: 11/24/2022]
Abstract
Spinal solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare mesenchymal malignancy. Radiographically, SFT/HPCs have a mutable appearance, with irregular borders, heterogeneous contrast enhancement, and variable but frequently hypointense T2 signal. We report a series of 5 neurosurgically managed spinal SFT/HPCs treated at our institution, with particular attention to 3 lesions demonstrating marked T2-hypointensity and differential diagnosis for the unusual finding of a "T2 dark" spinal lesion. Retrospective chart review of prospectively maintained surgical database, queried by diagnosis and site codes, 2002-2017. Retrospective radiographic review, with initial screening via keyword search of MR reports for "T2" and "hypointense." Four primary and one metastatic spinal SFT/HPCs were operatively treated during the study period (median follow-up 12 months; range 10-92). Three demonstrated marked T2 hypointensity on preoperative MRI, underwent primary resection-GTR in two, STR in one-and have remained progression-free on routine postoperative surveillance. Two patients with isointense lesions recurred within the follow-up period. Radiographic review identified a host of predominantly rare T2-hypointense lesions, including arteriovenous malformation, disk fragmentations, calcific arachnoiditis, calcifying pseudoneoplasm of the neuraxis, cavernoma, cord hemorrhage/acute blood, desmoid, granulocytic sarcoma, pigmented villonodular synovitis, Edheim-Chester, extramedullary hematopoiesis, IgG4-negative inflammatory pseudotumor, idiopathic hypertrophic pachymeningitis, B-cell lymphoma, primary melanoma neoplasm, melanotic schwannoma, meningioma, opacification of the posterior longitudinal ligament, osteoblastoma, osteochondroma, osteosarcoma, and synovial cyst. T2 hypointensity is associated with SFT/HPC, and may be an indicator relative indolence. "Dark" T2 spinal lesions are rare, with a narrow differential populated predominantly by rare entities.
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19
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Koeller KK, Shih RY. Intradural Extramedullary Spinal Neoplasms: Radiologic-Pathologic Correlation. Radiographics 2020; 39:468-490. [PMID: 30844353 DOI: 10.1148/rg.2019180200] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
While intradural extramedullary spinal disease varies widely, identification of tumors in this location and their radiologic manifestations greatly facilitates narrowing of the diagnostic considerations. Meningioma and schwannoma are the two most common intradural extramedullary tumors, and both are associated with neurofibromatosis. Meningiomas are most common in the thoracic spine and show a strong female predilection and a clinical manifestation related to compression of the spinal cord or nerve roots. Schwannomas typically are associated with radicular pain and other sensory symptoms. Melanotic schwannoma frequently shows T1 hyperintensity at MRI related to the presence of paramagnetic free radicals in melanin. Neurofibroma, known for its T2 hyperintensity, frequently involves the cervical spine, where it may make surgical resection challenging. Less commonly, malignant peripheral nerve sheath tumor commonly mimics the imaging appearance of a schwannoma but has decidedly more aggressive biologic behavior. In the cauda equina, myxopapillary ependymoma and paraganglioma are believed to arise from the filum terminale and have characteristic imaging manifestations based on their underlying pathologic features. Recent identification of a common genetic marker has led to reclassification of what had previously been regarded as separate tumors and are now known as solitary fibrous tumor/hemangiopericytoma. In the proper clinical setting, the presence of nodular intradural enhancement strongly suggests the presence of leptomeningeal metastatic disease, even when results of cerebrospinal fluid analysis are negative. This article highlights the characteristic neuroimaging manifestations of these neoplasms, with emphasis on radiologic-pathologic correlation. See Illumination by Frazier .
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Affiliation(s)
- Kelly K Koeller
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1011 Wayne Ave, Suite 320, Silver Spring, MD 20910 (K.K.K., R.Y.S.); Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.); Uniformed Services University of the Health Sciences, Bethesda, Md (R.Y.S.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.)
| | - Robert Y Shih
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1011 Wayne Ave, Suite 320, Silver Spring, MD 20910 (K.K.K., R.Y.S.); Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.); Uniformed Services University of the Health Sciences, Bethesda, Md (R.Y.S.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.)
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20
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Yi X, Wang J, zhang Y, Wang Z, Zhang Z, Gong G, Liu L, Xiang W, Liao W, Zee C, Chen BT. Renal solitary fibrous tumor/hemangiopericytoma: computed tomography findings and clinicopathologic features. Abdom Radiol (NY) 2019; 44:642-651. [PMID: 30225611 DOI: 10.1007/s00261-018-1777-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To retrospectively characterize the clinical, pathological, and computed tomography (CT) findings of renal solitary fibrous tumor/hemangiopericytoma (rSFT/HPC). METHODS Twelve patients with rSFT/HPCs were enrolled. The CT findings and clinicopathological features were retrospectively reviewed. RESULTS This study included six male and six female patients (median age: 47; age range: 20-82 years). Eight benign (grade I) and four malignant (grade III) rSFT/HPCs were identified. Of the 12 lesions, 10 were in the renal sinus near the renal pelvis, while two replaced the whole kidney. Five lesions were well-defined, five were partially ill-defined, and two were ill-defined. Mild (5/12) and intermediate (1/12) hydronephrosis was observed. On the unenhanced CT images, ten tumors showed slightly higher density when compared to the normal renal parenchyma, and two masses were isodense to hypodense. After intravenous contrast medium injection, three enhancement patterns were observed, including "prolonged enhancement" (PE) (6/12), "gradual enhancement" (4/12), and "early washout" (2/12). A central fibrous scar was found in five patients. Compared to the grade I lesions, the grade III rSFT/HPC lesions tended to be larger (maximal diameter > 10 cm) and more heterogeneous with a higher incidence of the PE pattern. CONCLUSIONS We have shown that rSFT/HPCs usually arise from the renal sinus, and present as lobulated, slightly hyperdense, gradually enhancing soft tissue masses. CT findings, including large size, heterogeneity, and the PE pattern, may assist in the pre-operative identification of malignant grade III rSFT/HPCs.
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21
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Wang J, Zhao K, Han L, Jiao L, Liu W, Xu Y, Niu H, Ke C, Shu K, Lei T. Solitary Fibrous Tumor/Hemangiopericytoma of Spinal Cord: A Retrospective Single-Center Study of 16 Cases. World Neurosurg 2018; 123:e629-e638. [PMID: 30554000 DOI: 10.1016/j.wneu.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE In this study, we retrospectively reviewed our experience in the surgical management of solitary fibrous tumor (SFT)/hemangiopericytomas (HPCs) of the spinal cord. METHODS Sixteen patients with SFT/HPCs of the spinal cord were enrolled in this study. Data on clinical presentation, radiologic findings, histopathologic features, surgical treatment, adjuvant therapy, and prognosis were retrospectively reviewed. Kaplan-Meier curves and log-rank tests were used to identify the prognostic factors for recurrence and overall survival (OS). RESULTS Our series included 6 men and 10 women, with a male/female ratio of 1:1.7. Magnetic resonance imaging (MRI) showed slightly hyperintense lesions on T2-weighted images for all 16 patients. All tumors showed positive immunohistochemical staining for signal transducer and activator of transcription 6. Statistical analysis of clinical data showed that age, gender, tumor location, tumor size, medullary compartment location, and Ki-67 index were not associated with recurrence and OS (P > 0.05). However, World Health Organization grade III was significantly associated with recurrence (P < 0.01). Gross total resection (GTR) and postoperative radiotherapy significantly reduced recurrence (P < 0.01 and P < 0.05), but only GTR showed remarkable benefits to improve OS (P < 0.05). CONCLUSIONS SFT/HPCs of spinal cord are rare neoplasms with a propensity to recur. Hyperintensity on T2-weighted magnetic resonance imaging combined with positive immunohistochemical staining for signal transducer and activator of transcription 6 are important clues for classification and differentiation of these tumors. The extent of resection, World Health Organization grade, and postoperative radiotherapy might be predictive factors for recurrence. Complete tumor resection should be sought whenever possible, and adjuvant radiotherapy is recommended after surgical resection. Moreover, regular and long-term follow-up is mandatory to monitor recurrence.
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Affiliation(s)
- Junwen Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Han
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liwu Jiao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihua Liu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Xu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongquan Niu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changshu Ke
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ting Lei
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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22
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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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23
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Lumbosacral Intraspinal Paraganglioma: Clinicopathologic and Computed Tomography/Magnetic Resonance Imaging Features of 13 Cases. World Neurosurg 2018; 113:e586-e597. [DOI: 10.1016/j.wneu.2018.02.102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 02/06/2023]
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24
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Zeng J, Liu H, Liu L, Liao W, Hu P, Wang X, Li X, Sun L, Zhang Y, Yi X. Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis. Dentomaxillofac Radiol 2018; 47:20170459. [PMID: 29658783 DOI: 10.1259/dmfr.20170459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To analyze the clinicopathological features and the CT and MRI features of patients with paranasal sinus fibrosarcoma. METHODS Seven patients with surgically and pathologically confirmed paranasal sinus fibrosarcoma were enrolled. Their CT and MRI data and imaging features were retrospectively analyzed in detail. RESULTS The study participants were two males and five females (median age, 43 years; range, 22-73 years). CT or MRI showed a well-defined (n = 5) or ill-defined (n = 2), irregular (n = 6) or oval (n = 1) mass, with heterogeneous (n = 7) density. The lesions were isointense (n = 4) or hypointense (n = 2) on T1 weighted images, and showed heterogeneous (n = 6) mild hypointensity on T2 weighted images. Expansive (n = 6) and osteolytic (n = 1) bone destruction were observed. The tumors showed marked heterogeneous delayed enhancement (n = 6) on contrast-enhanced MRI images. CONCLUSION Paranasal sinus fibrosarcomas should be included in the differential diagnosis when a sinonasal neoplasm appears as a well- or ill-defined unilateral large irregular mass with characteristic mild hypointensity on T2 weighted MR images and shows expansive or osteolytic bone destruction and a marked heterogeneous delayed contrast-enhancement pattern.
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Affiliation(s)
- Junjie Zeng
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Huaping Liu
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Lizhi Liu
- 2 Department of Imaging Diagnosis Center, Sun Yat-sen University Cancer Center , Guangzhou , China
| | - Weihua Liao
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Ping Hu
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xiaoyi Wang
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xuejun Li
- 3 Department of Neurosurgery, Xiangya Hospital, Central South University , Changsha , China
| | - Lunquan Sun
- 4 Center for Molecular Medicine,Xiangya Hospital, Central South University , Changsha , China
| | - Youming Zhang
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xiaoping Yi
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
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Surgical management of spinal solitary fibrous tumor/hemangiopericytoma: a case series of 20 patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:891-901. [DOI: 10.1007/s00586-017-5376-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 12/20/2022]
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