1
|
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.
Collapse
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
| | | | | |
Collapse
|
2
|
Yamada CAF, Narvaez EDO, Yamaki VN, Pfann RZ, Neville IS, Amaral LLFD. Cervical solitary fibrous tumor: case report and literature review. BJR Case Rep 2021; 7:20210058. [PMID: 35300229 PMCID: PMC8906161 DOI: 10.1259/bjrcr.20210058] [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: 03/18/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare neoplasms in the spinal canal. There are few studies addressing SFT/hemangiopericytomas with no distinctive clinical characteristics, no conclusive radiological findings or even a well-defined best treatment strategy. We described a rare case of cervical SFT/hemangiopericytomas in a young patient with spinal cord compression. There are many differential diagnoses for spinal dural-based masses of which meningiomas are the most common. Surgeons and oncologists should be aware of differentials of dural-based masses in the spinal cord for surgical decision making and to guide treatment.
Collapse
Affiliation(s)
- Camilla Akemi Felizardo Yamada
- Departament of Oncology, Hospital BP, São Paulo, Brazil
- Latin American Cooperative Oncology Group - LACOG, Sao Paulo, Brazil
| | | | - Vitor Nagai Yamaki
- Department of Neurosurgery, Universidade de São Paulo, São Paulo, Brazil
| | | | - Iuri Santana Neville
- Department of Neurosurgery, Universidade de São Paulo, São Paulo, Brazil
- Instituto do Cancer do Estado de São Paulo – Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms of fibroblastic origin. They commonly arise from visceral pleura, but also arise from nonserosal sites such as meninges, central nervous system parenchyma, and spinal cord. In the spinal cord, SFTs commonly arise from the thoracic spinal cord, followed by cervical spinal cord, lumbar spinal cord, and sacrum. Histologically, SFTs can be similar to hemangiopericytoma, schwannoma, fibrous meningioma, fibroma, gliofibroma, and ependymoma. Immunohistochemistry (IHC) plays an important role in differentiating SFTs from other identical tumors. Here, we report a rare case of SFT of the cervical spinal cord, which was initially reported as hemangiopericytoma, and the diagnosis of SFT was confirmed by IHC.
Collapse
Affiliation(s)
- Mallikarjuna Rao Koduru
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Sandeep Ail
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Jayarama Shetty
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Vijith Shetty
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| |
Collapse
|
5
|
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
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Yang C, Xu Y, Liu X. Spinal Intramedullary Solitary Fibrous Tumor: A Rare and Challenging Diagnosis. Cancer Manag Res 2019; 11:10321-10326. [PMID: 31849521 PMCID: PMC6911315 DOI: 10.2147/cmar.s231019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 12/03/2019] [Indexed: 11/29/2022] Open
Abstract
Background Solitary fibrous tumor (SFT) is a benign neoplasm arising in the soft tissue, which can occur anywhere in the body, while it is predominantly found in the visceral pleura. Spinal SFT is quite uncommon, with limited cases having been reported in the literature; especially, SFT occurring in the intramedullary site is extremely rare. Case presentation We present a case of a 35-year-old woman presenting with progressive numbness and weakness in the legs and urinary incontinence. Magnetic resonance imaging (MRI) showed an intramedullary lesion with bright enhancement. A diagnosis of spinal hemangioblastoma was suspected, and thus a three-dimensional computed tomographic angiography reconstruction was requested, which also demonstrated an angiomatous lesion. The tumor was completely resected under neurophysiological monitoring. However, histopathological and immunohistochemical examinations revealed an SFT. No adjuvant radiotherapy or chemotherapy was scheduled. The symptoms were relieved completely, and no recurrence or progression was noted during the follow-up. Conclusion Though SFT has been considered similar to malignant hemangiopericytoma and the histological classification has always been controversial, the intramedullary location and benign behavior in the present case add to the current understandings of this extremely rare entity.
Collapse
Affiliation(s)
- Chenlong Yang
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Yulun Xu
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, People's Republic of China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, People's Republic of China
| |
Collapse
|
9
|
Sun LJ, Dong J, Gao F, Chen DM, Li K, Liu J, Zhang C, Tohti M, Yang XP. Intracranial solitary fibrous tumor: Report of two cases. Medicine (Baltimore) 2019; 98:e15327. [PMID: 31027104 PMCID: PMC6831225 DOI: 10.1097/md.0000000000015327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/17/2019] [Accepted: 03/25/2019] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Intracranial solitary fibrous tumor (ISFT) is a rare spindle cell tumor derived from dendritic mesenchymal cells expressing CD34 antigens, which are widely distributed in human connective tissues. PATIENT CONCERNS In two case reports, we describe a 61-year-old woman and a 42-year-old man who present with intracranial malignant SFTs. Computed tomography or magnetic resonance imaging of head revealed that the largest size is about 3.3 × 3.0 cm in left occipital part and 4.0 × 3.0 cm in right skull base. DIAGNOSIS Postoperative pathological results demonstrated that all of two cases are SFT. Case one: Immunohistochemical examination demonstrated a strong immunoreaction for cluster of differentiation (CD)34, B-cell lymphoma 2 (Bcl-2) and Vimentin (Vim). Case two: The tumor was distinctively positive for Bcl-2, but not for CD34 and Vim. INTERVENTIONS One of the two patients recurred 6 years after the first tumor resection. After the recurrence, two gamma knife treatments were given, and another operation was performed about five years later. In one case, only tumor resection was performed. OUTCOMES Case one: The postoperative neurological status was substantially improved and regular follow-up examinations for 6 months postsurgery have shown that the patient is currently disease-free. Case two: The patient achieved a good outcome, with no epilepsy or other neurological symptoms experienced on a regular 6-month follow-up. The patient is currently disease free. LESSONS Imaging findings can be used to assist the diagnosis. The diagnostic method is pathology, and total surgical resection is the most effective treatment. The main treatment methods were total resection, supplemented by radiotherapy and chemotherapy if necessary.
Collapse
Affiliation(s)
- Lian-Jie Sun
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Jun Dong
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Feng Gao
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Dong-Ming Chen
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Ke Li
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Jiang Liu
- Department of Neurosurgery, China-Japan Friendship Hospital, No. 2, Yinghua East St., ChaoYang District, Beijing, China
| | - Cheng Zhang
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Maitiyiming Tohti
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Xiao-Peng Yang
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Pearre DC, Federspiel JJ, Grumbine FC. Solitary fibrous tumor of the vulva resulting in spinal metastasis: A case report. Gynecol Oncol Rep 2017; 22:97-99. [PMID: 29201988 PMCID: PMC5700819 DOI: 10.1016/j.gore.2017.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/16/2022] Open
Abstract
•Solitary fibrous tumors are typically indolent tumors of the pleura.•Primary origin in the female reproductive organs is rare, as are aggressive forms.•We report a case of a vulvar solitary fibrous tumor, notable for extensive spinal metastasis.
Collapse
Affiliation(s)
- Diana C Pearre
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jerome J Federspiel
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Francis C Grumbine
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Greater Baltimore Medical Center, Baltimore, MD, USA
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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
| |
Collapse
|
14
|
Walker CT, Amene CS, Pannell JS, Santiago-Dieppa DR, Rennert RC, Hansen LA, Khalessi AA. Hemorrhagic intramedullary solitary fibrous tumor of the conus medullaris: case report. J Neurosurg Spine 2015; 23:438-43. [DOI: 10.3171/2015.1.spine13915] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The differential diagnosis of spinal tumors is guided by anatomical location and imaging characteristics. Diagnosis of rare tumors is made challenging by abnormal features. The authors present the case of a 47-year-old woman who presented with progressive subacute right lower-extremity weakness and numbness of the right thigh. Physical examination further revealed an extensor response to plantar reflex on the right and hyporeflexia of the right Achilles and patellar reflexes. Magnetic resonance imaging of the lumbar spine demonstrated an 8-mm intramedullary exophytic nodule protruding into a hematoma within the conus medullaris. Spinal angiography was performed to rule out an arteriovenous malformation, and resection with hematoma evacuation was completed. Pathological examination of the resected mass demonstrated a spindle cell neoplasm with dense bundles of collagen. Special immunostaining was performed and a diagnosis of solitary fibrous tumor (SFT) was made. SFTs are mesenchymally derived pleural neoplasms, which rarely present at other locations of the body, but have been increasingly described to occur as primary neoplasms of the spine and CNS. The authors believe that this case is unique in its rare location at the level of the conus, and also that this is the first report of a hemorrhagic SFT in the spine. Therefore, with this report the authors add to the literature the fact that this variant of an increasingly understood but heterogeneous tumor can occur, and therefore should be considered in the differential of clinically similar tumors.
Collapse
Affiliation(s)
- Corey T. Walker
- 1Division of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Chiazo S. Amene
- 2Division of Neurosurgery, University of California-San Diego; and
| | | | | | | | - Lawrence A. Hansen
- 3Department of Pathology, University of California-San Diego, California
| | | |
Collapse
|
15
|
Bruder M, Tews D, Mittelbronn M, Capper D, Seifert V, Marquardt G. Intramedullary Solitary Fibrous Tumor—A Benign Form of Hemangiopericytoma? Case Report and Review of the Literature. World Neurosurg 2015; 84:189.e7-189.e12. [DOI: 10.1016/j.wneu.2015.02.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 12/18/2022]
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Solitary fibrous tumour with intramedullary component: Case report and review of the literature. Neurol Neurochir Pol 2014; 48:144-9. [DOI: 10.1016/j.pjnns.2013.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/02/2013] [Indexed: 11/20/2022]
|
18
|
Turel MK, Rajshekhar V. Primary spinal extra-osseous intradural mesenchymal chondrosarcoma in a young boy. J Pediatr Neurosci 2013; 8:111-2. [PMID: 24082926 PMCID: PMC3783715 DOI: 10.4103/1817-1745.117838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Primary spinal intradural mesenchymal chondrosarcoma is rare. We report the case of a 6-year-old boy to emphasize on the importance of considering this entity as differential diagnosis even when the lesion is purely intradural with no bony involvement.
Collapse
Affiliation(s)
- Mazda K Turel
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | | |
Collapse
|
19
|
Two patients with a solitary fibrous tumor of the thoracic spinal cord. J Clin Neurosci 2013; 20:317-9. [DOI: 10.1016/j.jocn.2012.02.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 02/02/2012] [Accepted: 02/14/2012] [Indexed: 01/23/2023]
|
20
|
Mariniello G, Napoli M, Russo C, Briganti F, Giamundo A, Maiuri F, De Caro MDB. MRI Features of Spinal Solitary Fibrous Tumors. Neuroradiol J 2012; 25:610-6. [DOI: 10.1177/197140091202500516] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 09/14/2012] [Indexed: 11/17/2022] Open
Abstract
Spinal solitary fibrous tumors (SFT) are very rare neoplasms occurring in the spinal canal, with only 38 cases reported in ten years since the first description. We describe two cases of SFT of the spine and review 33 well-documented cases in the literature to define distinctive radiological and surgical features raising the suspicion of a spinal SFT before histological verification. A 67-year-old man with cervical myeloradiculopathy had a large extramedullary tumor of the cervical spinal canal extending from C4 to C7. On MRI the tumor was isointense on T1-sequences and hypointense on T2-sequences, and had marked contrast enhancement. At surgery, the tumor was intradural extramedullary, with no dural or root attachment, but it was adherent to the cord. Complete tumor removal was achieved with good outcome. A 75-year-old man with progressive thoracic myelopathy had an intramedullary tumor at C6 and C7 level, which was hypointense on T1- and T2-weighted images of MRI. At surgery, the tumor was intramedullary and strongly adherent to the cord; it was successfully removed. Both tumors were composed of elongated cells with a collagen-matrix background. Immunohistochemical staining was positive for vimentin, CD34, and bcl-2, and negative for EMA and S-100 protein. A careful analysis of our own and the other reported cases of spinal SFTs may disclose some peculiar features of this rare tumor. A spinal intramedullary or extramedullary tumor, hypointense on T2-weighted images of MRI, which intraoperatively shows hard consistency, scarce vascularization, no nerve root involvement, no or weak dural attachment, absence of arachnoidal interface, and adherence to the spinal cord may suggest the diagnosis of SFT.
Collapse
Affiliation(s)
- G. Mariniello
- Chair of Neurosurgery, Department of Neurological Sciences, “Federico II” University of Naples; Naples, Italy
| | - M. Napoli
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - C. Russo
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - F. Briganti
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - A. Giamundo
- Chair of Neurosurgery, Department of Neurological Sciences, “Federico II” University of Naples; Naples, Italy
| | - F. Maiuri
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - M.L. Del Basso De Caro
- Department of Biomorphology, Section of Pathology, “Federico II” University of Naples; Naples, Italy
| |
Collapse
|
21
|
Cincu R, Rodriguez R, Perez A, Blanco T, Arrotegui I, Barcia C. Solitary fibrous tumor of the thoracic spine. J Neurosci Rural Pract 2011; 1:118-9. [PMID: 21808519 PMCID: PMC3139340 DOI: 10.4103/0976-3147.71730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Rafael Cincu
- Department of Neurosurgery, Valencia University General Hospital, Valencia, Spain
| | | | | | | | | | | |
Collapse
|
22
|
Bisceglia M, Dimitri L, Giannatempo G, Carotenuto V, Bianco M, Monte V, D’Angelo V, Magro G. Solitary Fibrous Tumor of the Central Nervous System. Int J Surg Pathol 2011; 19:476-86. [DOI: 10.1177/1066896911405655] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Solitary fibrous tumor (SFT) of the central nervous system was first described in 1996. A number of cases have been reported since. The authors present 5 new cases: 4 intracranial and 1 intraspinal. All patients were adults (age range, 47 to 75 years); 4 were male and 1 female; 4 cases were primary tumors; and 1 was a second tumor recurrence. All patients were surgically treated with gross total removal. All cases were histologically examined with immunohistochemical confirmation; 2 tumors exhibited diffuse classic histology, 1 tumor was a cellular variant, 1 tumor was myxoid, and 1 was predominantly classic with focal myxoid features and focally pleomorphic. The postoperative course was uneventful in all. The patient with the cellular variant experienced 2 local recurrences and eventually died of disease 10 years after the initial diagnosis. The patient with the myxoid variant—the tumor studied—which was the second recurrence of a previously misdiagnosed fibrous meningioma surgically treated 15 years earlier, had a recurrence after 2 years for the third time and eventually died of disease. Three patients are alive and well 11.6, 6, and 4 years after surgery. SFT is a rare tumor that needs to be differentiated from some mimickers, mainly fibrous meningioma, hemangiopericytoma, and with regard to the myxoid variant, also adult-onset myxochordoid meningioma and myxoid peripheral nerve sheath tumor. Immunohistochemistry is crucial for the correct diagnosis of SFT. The authors also performed a review of the literature and found a little more than 200 cases on record.
Collapse
Affiliation(s)
- Michele Bisceglia
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Lucia Dimitri
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | | | - Vincenzo Carotenuto
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Mario Bianco
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Vincenzo Monte
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Vincenzo D’Angelo
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Gaetano Magro
- University and Polyclinic Hospital of Catania, Catania, Italy
| |
Collapse
|
23
|
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.
Collapse
Affiliation(s)
- Kyle M Fargen
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA.
| | | | | | | | | | | |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Ishii K, Nakamura M, Matsumoto M, Mukai M, Toyama Y, Chiba K. Intramedullary solitary fibrous tumor of the spinal cord. J Orthop Sci 2009; 14:450-4. [PMID: 19662481 DOI: 10.1007/s00776-009-1339-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 01/28/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
26
|
Hashimoto K, Miyamoto K, Hosoe H, Kawai G, Kikuike K, Shimokawa K, Suzuki N, Matsuo M, Kodama H, Shimizu K. Solitary fibrous tumor in the cervical spine with destructive vertebral involvement: a case report and review of the literature. Arch Orthop Trauma Surg 2008; 128:1111-6. [PMID: 18060553 DOI: 10.1007/s00402-007-0529-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Recently, solitary fibrous tumors occurring in spine-related lesions have been reported. However, the destruction of vertebral bodies by this type of tumor has not been reported. MATERIALS AND METHODS A 71-year-old female presented with pain from a mass on the right side of her neck. Plain radiographs of the cervical spine showed collapse of the C5 vertebral body and dislocation of the C4 vertebral body. The MRI image showed a large mass surrounding C4 and C5, which had low signal intensity in the T1W image and high signal intensity in the T2W image. At first, resection of the tumor and spinal fusion was performed by anterior approach. RESULTS Histology revealed a solitary fibrous tumor with proliferating spindle cells. Immunohistochemistry showed positive stains for vimentin and CD34. One year postoperatively, a local recurrence manifested extensive destruction of the C4 and C5 vertebral bodies. Then, palliative surgery with posterior cervical instrumentation and radiation therapy were performed. Because the destruction proceeded and the rods were broken 2 years after, she underwent additional occipito-cervical instrumentation. CONCLUSIONS This is the first report of a solitary fibrous tumor that involves the destruction of the spinal structure. An extensive destruction of the vertebral body by the solitary fibrous tumor needs to be aware in treating this tumor with spinal involvement.
Collapse
Affiliation(s)
- Koji Hashimoto
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu City, Gifu, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
STUDY DESIGN Case report. OBJECTIVE We present a case of an ambulatory patient with a solitary fibrous tumor of the spinal cord. SUMMARY OF BACKGROUND DATA Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor of the pleural cavity, increasingly recognized at numerous extrathoracic sites, including, among others, prostate, kidney, and thyroid. The spinal cord is an extremely rare localization of SFTs with only 17 cases reported in the literature since 1996. Although SFTs are usually indolent neoplasms that are cured with complete surgical resection, malignant transformation has been described within histologically benign SFTs. However, no cases of malignant dissemination have been described in this localization. METHODS Discussion of the patient's clinical and radiologic history with a review of the relevant background literature. RESULTS We report the first case of spinal cord SFT with visceral dissemination years after the primary diagnosis, despite benign histologic features of the primary tumor. CONCLUSION This finding may indicate that long-term follow-up might be necessary in these patients. In addition, metastatic radical surgery of SFTs should be considered to achieve long-term survival since there are no currently available effective systemic therapies.
Collapse
|
28
|
Tsai HY, Liu GC, Kang WY, Lee KS, Lin WC. Solitary fibrous tumor of the cerebellopontine angle: A case report with imaging analysis. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.ejrex.2006.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|