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Recurrent Solitary Fibrous Tumor in Intradural Extramedullary Space: Case Report and Review of the Literature. Case Rep Oncol Med 2021; 2021:4559749. [PMID: 34845431 PMCID: PMC8627340 DOI: 10.1155/2021/4559749] [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: 05/11/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare neoplasm arising from spindle cells and most commonly arising from pleura. Spinal SFT/HPC is a rare entity; hence, it is not on the top of the differential diagnosis list when a clinician faces a spinal lesion. In the review of the literature, there exist less than 50 case reports of intradural extramedullary SFT/HPC. Here, we present a 54-year-old female patient who underwent subtotal surgical excision of an intradural extramedullary spinal mass pathologically reported to be SFT/HPC and had symptomatic recurrence in the 3rd year of follow-up. Surgical intervention was unachievable and the patient was given 45 Gy to the surgical cavity followed by a 5.4 Gy boost to visible tumor with external radiotherapy. Patient reported significant relief of her symptoms. We aim to contribute to the formation of a treatment algorithm for this rare entity.
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2
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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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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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4
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Glauser G, Sharma N, Kritikos M, Malhotra NR, Choudhri O. Cervical, Intradural Extramedullary Solitary Fibrous Tumor of the Spinal Cord: A Case Report and Review of the Literature. Asian J Neurosurg 2020; 15:204-209. [PMID: 32181204 PMCID: PMC7057895 DOI: 10.4103/ajns.ajns_213_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/25/2019] [Indexed: 12/18/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare, spindle cell neoplasms of the mesenchymal origin. Lesions localized to the spine are exceptionally uncommon, only described in the literature in case reports and small case series. While these lesions are typically benign, there are a few reports in which they recur or present as malignancies. The patient presented in the case herein was a 72-year-old male, who presented with a 1-year history of lower extremity weakness, pain, and numbness and was found to have a cervical, intradural extramedullary tumor. In addition to the case report, the authors perform a thorough review of all previously published cases of spinal SFT.
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Affiliation(s)
- Gregory Glauser
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Sharma
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Kritikos
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil Rainer Malhotra
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Omar Choudhri
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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5
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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.
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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
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Spinal Solitary Fibrous Tumor/Hemangiopericytoma: A Clinicopathologic and Radiologic Analysis of Eleven Cases. World Neurosurg 2017; 104:318-329. [DOI: 10.1016/j.wneu.2017.05.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 12/20/2022]
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7
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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]
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8
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Hwang US, Kim SB, Jo DJ, Kim SM. Intramedullary solitary fibrous tumor of cervicothoracic spinal cord. J Korean Neurosurg Soc 2014; 56:265-8. [PMID: 25368773 PMCID: PMC4217067 DOI: 10.3340/jkns.2014.56.3.265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/13/2014] [Accepted: 09/06/2014] [Indexed: 11/27/2022] Open
Abstract
Solitary fibrous tumor is rare benign mesenchymal neoplasm. The spinal solitary fibrous tumor is extremely rare. The authors experienced a case of intramedullary solitary fibrous tumor of cervicothoracic spinal cord in a 48-year-old man with right lower extremity sensory disturbance. Spinal MRI showed intradural mass lesion in the level of C7-T1, the margin between the spinal cord and tumor was not clear on MRI. A Left unilateral laminectomy and mass removal was performed. Intra operative finding, the tumor boundary was unclear from spinal cord and it had intramedullary and extramedullary portion. After surgery, patient had good recovery and had uneventful prognosis. Follow up spinal MRI showed no recurrence of tumor.
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Affiliation(s)
- Ui Seung Hwang
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung Bum Kim
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dae Jean Jo
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung Min Kim
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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9
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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.
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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
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10
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Kasper E, Boruchow S, Lam FC, Zinn PO, Anderson M, Mahadevan A. "Hitting all the right markers to save a life" Solitary fibrous tumors of the central nervous system: Case series and review of the literature. Surg Neurol Int 2012; 3:83. [PMID: 22937483 PMCID: PMC3424684 DOI: 10.4103/2152-7806.99173] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 06/11/2012] [Indexed: 12/16/2022] Open
Abstract
Background: Solitary fibrous tumors (SFTs) of the central nervous system are uncommon. Their biological features remain largely unknown; hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data. For this reason, we present two cases of large SFTs to illustrate a comprehensive review. Methods: This was a retrospective analysis of two patients: a 65-year-old male with a left parietooccipital lesion and a 70-year-old female with a right parietal convexity mass. Results: Gross total resection was performed in the male patient with no recurrence 30 months after resection. The second patient received stereotactic radiosurgery for what was initially thought to be a parafalcine meningioma; however, continued growth 1 year later prompted an open resection, with pathology indicative of an SFT. The tumor recurred the following year requiring repeat resection. Unfortunately, due to the aggressive nature of the lesion, the patient eventually succumbed to tumor burden a year later. Conclusion: Based on the literature review, the sometimes observed aggressive growth pattern, and also, the potential for malignant transformation, we recommend complete resection of SFTs with close sequential follow-up.
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Affiliation(s)
- Ekkehard Kasper
- Division of Neurosurgery, Beth Israel Deaconess Medical Centre, Harvard University, Boston, Massachusetts, USA
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11
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Bouvier C, Métellus P, de Paula AM, Vasiljevic A, Jouvet A, Guyotat J, Mokhtari K, Varlet P, Dufour H, Figarella-Branger D. Solitary fibrous tumors and hemangiopericytomas of the meninges: overlapping pathological features and common prognostic factors suggest the same spectrum of tumors. Brain Pathol 2011; 22:511-21. [PMID: 22082190 DOI: 10.1111/j.1750-3639.2011.00552.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Meningeal solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are distinct entities in the World Health Organization (WHO) classification of central nervous system (CNS) tumors while they belong to the same spectrum of tumors in other locations. Well-defined histological prognostic factors are also lacking for these tumors. In order to clarify the relationship between SFT and HPC and to find histological and immunohistochemical prognostic factors, we carried out a retrospective study in 89 patients. The following histological parameters were recorded: hypercellularity, collagenic areas, cytonuclear atypias, necrosis, mitotic count per 10 high-power fields, vasculo-nervous adherences defined by engulfment of vessel or nerve by the tumor, brain infiltration. We found overlapping histological and immunohistochemical features between SFT and HPC. The most relevant histological prognostic factors in the whole cohort for both progression-free survival (PFS) and overall survival (OS) in univariate analysis were hypercellularity, high mitotic count (>5 per 10 high-power fields) and necrosis. On the basis of these results, we propose a new grading scheme for these tumors which was of pronostic value for both PFS and OS in uni- and multivariate analysis. As extent of surgery was also a prognostic factor for both PFS and OS in univariate analysis, we propose that management of SFT/HPC might be based both on quality of removal and histological grade.
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Affiliation(s)
- Corinne Bouvier
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France.
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12
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Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996-July 2011). Adv Anat Pathol 2011; 18:356-92. [PMID: 21841406 DOI: 10.1097/pap.0b013e318229c004] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We reviewed the world literature on solitary fibrous tumors of the central nervous system from August 1996 to July 2011, focusing on both clinicopathological features and diagnostic findings. The anatomical distribution of the 220 cases reported so far reveals that most are intracranial and just over one-fifth are intraspinal. In decreasing frequency, intracranial tumors involve the supratentorial and infratentorial compartments, the pontocerebellar angle, the sellar and parasellar regions, and the cranial nerves. Intraspinal tumors are mainly located in the thoracic and cervical segments. Although most solitary fibrous tumors of the central nervous system are dural based, a small subset presents as subpial, intraparenchymal, intraventricular, or as tumors involving the nerve rootlets with no dural connection. Preoperative imaging and intraoperative findings suggest meningioma, schwannoma or neurofibroma, hemangiopericytoma, or pituitary tumors. Immunohistochemistry is critical to establish a definitive histopathological diagnosis. Vimentin, CD34, BCL2, and CD99 are the most consistently positive markers. The usual histologic type generally behaves in a benign manner if complete removal is achieved. Recurrence is anticipated when resection is subtotal or when the tumor exhibits atypical histology. The proliferative index as assessed by MIB1 labeling is of prognostic significance. Occasionally, tumors featuring conventional morphology may recur, perhaps because of minimal residual disease left behind during surgical extirpation. Rare extracranial metastases and tumor-related deaths are on record. Surgery is the treatment of choice. Stereotactic and external beam radiation therapy may be indicated for postsurgical tumor remnants and for unresectable recurrences. Long-term active surveillance of the patients is mandatory.
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13
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Motoori K, Hanazawa T, Yamakami I, Sugimoto A, Ito H. Intra- and extracranial solitary fibrous tumor of the trigeminal nerve: CT and MR imaging appearance. AJNR Am J Neuroradiol 2010; 31:280-1. [PMID: 19762459 DOI: 10.3174/ajnr.a1702] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We describe a rare case of SFT existing along the mandibular division of the trigeminal nerve and extending down into the infratemporal fossa through the foramen ovale. The tumor showed heterogeneous hypointensity on T2-weighted images and marked enhancement on CT and MR images.
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Affiliation(s)
- K Motoori
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba City, Chiba, Japan.
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14
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Ogungbo B, Prakash S, Kulkarni G, Bradey N, Marks SM, Scoones D. Cervical intra-/extramedullary solitary fibrous tumour. Br J Neurosurg 2009; 19:254-7. [PMID: 16455529 DOI: 10.1080/02688690500208528] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A 53-year-old man presented with a 9-month history of symptoms of right-sided weakness, tingling and hypersentivity to clothes on both sides of the body. MRI revealed a large intraspinal intradural tumour at the level of C3-C4 in the cervical cord. The final histology was a solitary fibrous tumour (SFT) of the cervical spinal cord. The radiological diagnosis, surgical management and histology are reviewed.
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Affiliation(s)
- B Ogungbo
- Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK.
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15
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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.
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Affiliation(s)
- Koji Hashimoto
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu City, Gifu, Japan.
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16
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Anders JO, Aurich M, Lang T, Wagner A. Solitary fibrous tumor in the thigh: review of the literature. J Cancer Res Clin Oncol 2005; 132:69-75. [PMID: 16283380 DOI: 10.1007/s00432-005-0055-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Accepted: 10/14/2005] [Indexed: 11/27/2022]
Abstract
Solitary fibrous tumors (SFT) of extremities, especially the thighs are very rare. Despite SFTs are generally benign, well-circumscribed soft tissue tumors new cases should be presented and followed up carefully to monitor their biological behavior. In general for tumor classification a biopsy is state of the art. Histological including immunohistochemical patterns for SFTs are defined. MRI and ultrasound are not sufficient for differential diagnosis. Once property identified and defined by size and location, resection with intact tumor capsule may result in full recovery of the patient. Reviewing the literature there are no validated reasons for a wider resection. The current patient was a 41-year-old male. Four years after an arthroscopy of the left knee the patient has been suffering an ongoing swelling of the lateral thigh. Because MRI scan data suggested a synovial sarcoma a biopsy was performed. The tumor was classified as a benign SFT. The diagnosis based on histological findings and the presence of the positive immunohistochemical markers Vimentin, CD34, and CD99. The complete tumor resection with intact capsule was achieved in a final operation. Clinical and in MRI after 54-month outcome period there were no local recurrences.
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Affiliation(s)
- J O Anders
- Department of Orthopaedic Surgery, Friedrich-Schiller-University Jena, Waldkrankenhaus Rudolf Elle Eisenberg, Klosterlausnitzerstr. 81, 07607 Eisenberg, Germany.
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17
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Jallo GI, Roonprapunt C, Kothbauer K, Freed D, Allen J, Epstein F. Spinal Solitary Fibrous Tumors: A Series of Four Patients: Case Report. Neurosurgery 2005; 57:E195; discussion E195. [PMID: 15987560 DOI: 10.1227/01.neu.0000163420.33635.9f] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2004] [Accepted: 02/10/2005] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE AND IMPORTANCE:
Intraspinal solitary fibrous tumors, which are rare mesenchymal tumors, have previously been reported as case reports. We review our experience and, to our knowledge, the first small institutional series with respect to clinical presentation, diagnosis, surgical management, pathohistological analysis, progression-free survival, and long-term outcome.
CLINICAL PRESENTATION:
In this retrospective review, four patients (three male and one female) ranging in age from 17 to 59 years (mean, 38.5 yr) had spinal solitary fibromas located throughout the spinal canal. Three tumors were located in the thoracic region and one in the cervical spine. All patients presented with pain and paresthesia. Two patients had an associated spinal deformity. All had gross total resection as confirmed by postoperative imaging studies.
INTERVENTION:
All four patients underwent surgical treatment for spinal solitary fibromas. None of these patients underwent irradiation or chemotherapy after surgery at our center; therefore, outcome was attributed to surgery alone. There were no surgical deaths, and the 5-year actuarial survival rate was 100%. At the most recent follow-up examination, neurological function was stable or improved in 90% of patients.
CONCLUSION:
Patients with solitary fibrous tumors have a long survival. These tumors have an indolent course, and radiotherapy or chemotherapy seems to be unnecessary.
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Affiliation(s)
- George I Jallo
- Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Pakasa NM, Pasquier B, Chambonnière ML, Morrison AL, Khaddage A, Perret AG, Dumollard JM, Barral FG, Péoc'h M. Atypical presentations of solitary fibrous tumors of the central nervous system: an analysis of unusual clinicopathological and outcome patterns in three new cases with a review of the literature. Virchows Arch 2005; 447:81-6. [PMID: 15926073 DOI: 10.1007/s00428-005-1220-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2004] [Accepted: 01/28/2005] [Indexed: 10/25/2022]
Abstract
Central nervous system (CNS) solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms recognized less than a decade ago. Approximately 60 cases of SFT have been reported in the central nervous system. We describe three atypical SFTs of the CNS, two intracranial and one within the spine. One intracranial SFT arose from the sella turcica and expanded into the suprasellar areas. It relapsed twice during the 3 years following partial resection, and the MiB 1 labeling index steadily increased without obvious malignant transformation. The second SFT arose from the confluence of the sinuses, widely invaded the lateral sinus and adjacent bones, had a low MiB 1 index and has not recurred after 5 years. The intraspinal tumor occurred at T5-T7 in a patient with multiple café-au-lait spots, was predominantly myxoid and developed a second similar lesion at S3-S5 14 years later. The MiB 1 index was lower in the second tumor. Immunohistochemistry confirmed that all were SFTs. These atypical presentations gave us an opportunity to provide further information about the natural histological course of CNS SFTs.
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Affiliation(s)
- Nestor M Pakasa
- Department of Pathology, Centre Hospitalier Universitaire de Saint-Etienne, Saint Etienne, France
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