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Ciuffi A, Saleh C, Terreni MR, Jaszczuk P, Zekaj E, Menghetti C, Franzini A, Servello D. A cervical solitary fibrous tumor with intramedullary invasion. Surg Neurol Int 2022; 13:343. [PMID: 36128101 PMCID: PMC9479521 DOI: 10.25259/sni_538_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: 06/10/2022] [Accepted: 07/22/2022] [Indexed: 11/04/2022] Open
Abstract
Solitary fibrous tumor is a tumor originating from the mesenchymal cells, which occurrence in the central nervous system is extremely rare and was described in few patients as to yet. We report on a 53-years old male patient presenting with right upper limb radicular pain and ipsilateral limbs paresis, who was diagnosed with a cervical spinal lesion which, after surgical resection, resulted to be a solitary fibrous tumor (SFT). We discuss imaging, clinical and histopathological findings to allow considering this tumor early in the differential diagnosis.
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Affiliation(s)
- Andrea Ciuffi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Lombardia, Italy,
| | - Christian Saleh
- Clinic for Forensics, University Psychiatric Clinic Basel, Basel, Switzerland,
| | - Maria Rosa Terreni
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy,
| | - Phillip Jaszczuk
- Department of Spinal Surgery and Spinal Cord Surgery, Swiss Paraplegic Centre, Notwill, Switzerland,
| | - Edvin Zekaj
- Department of Neurosurgery, IRCCS Istituto Ortopedico Galeazzi, Milan,
| | - Claudia Menghetti
- Department of Neurosurgery, IRCCS Istituto Ortopedico Galeazzi, Milan,
| | - Andrea Franzini
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy
| | - Domenico Servello
- Department of Neurosurgery, IRCCS Istituto Ortopedico Galeazzi, Milan,
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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.
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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
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3
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Intradural-extramedullary solitary fibrous tumor of the thoracic spine: A case report. Radiol Case Rep 2020; 15:709-711. [PMID: 32280404 PMCID: PMC7139141 DOI: 10.1016/j.radcr.2020.02.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 11/21/2022] Open
Abstract
Spinal solitary fibrous tumors are extremely rare neoplasms and of those, intradural extramedullary location is even rarer. A 64-year-old male presented to the emergency department with worsening right leg pain over 1 month. Whole spine magnetic resonance imaging revealed a well-circumscribed mass with low T1 and markedly low T2 signal intensity at the level of T1-2. Spine computed tomography showed no evidence of calcification or acute hemorrhage. Surgical removal was performed and the final diagnosis was intradural extramedullary solitary fibrous tumor.
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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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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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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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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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Mansilla Fernández B, Román de Aragón M, Paz Solís JF, García Feijoo P, Roda Frade J, Regojo Zapata MR. Solitary fibrous tumor: A clinical case. Neurocirugia (Astur) 2018; 30:33-37. [PMID: 29496403 DOI: 10.1016/j.neucir.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/04/2017] [Accepted: 01/16/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Solitary fibrous tumor (TFS) is a rare tumor of mesenchymal origin, located mainly in the pleura. It is extraordinarily infrequent find it at the intraespinal level, being the thoracic region the most frequent. CASE PRESENTATION We present the case of a 48-year-old patient with progressive ascending lower limb and myelopathy of one month of evolution, with intraspinal location at the D3-D4 level. It was surgically operated by posterior dorsal approach and D3-D4 laminoplasty, with an intradural tumor with an intramedullary component of approximately 18×12mm. The resection was complete and the pathological anatomy gave the diagnosis of solitary fibrous tumor. The patient is currently asymptomatic. DISCUSSION Complete tumor resection and histopathological features are the main prognostic factors. Surgery have a main role in this type of neoplasia. CONCLUSION There are few case published of solitary fibrous tumor with intraspinal localization. We apport another case to the literature.
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Affiliation(s)
| | | | | | | | - José Roda Frade
- Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España
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Abstract
RATIONALE Solitary fibrous tumors (SFTs) are rare spindle cell tumors that are most commonly found in the mediastinal pleura. Although there are increasingly more reports of extra-pleural SFTs, reports of SFTs in bone are very rare. To our knowledge, a SFT of the ilium has not yet been reported. With low specificity on computer tomograpy and magnetic resonance imaging, SFTs are easily misdiagnosed. PATIENT CONCERNS A 33-year-old man visited our hospital due to repeated right ilium pain for 3 months. The pain was dull and bearable, with no hip joint dyskinesia. The relevant physical examinations are negative. The patient was healthy before and had a negative family history. Radiologically, a large mass with inhomogeneous attenuation and intensity and obvious heterogeneous enhancement was misdiagnosed as a giant cell tumor of ilium. DIAGNOSES The man was diagnosed as the solitary fibrous tumor of right ilium. INTERVENTIONS The patient was performed an "incision biopsy of the right ilium" and "extended resection of tumor". OUTCOMES The pathology and immunohistochemistry was confirmed as the solitary fibrous tumors. The patient was followed-up by computed tomography of pelvis in local hospital every 6 mouths, and there is no recurrence and any symptoms. LESSONS We learned that the solitary fibrous tumor could locate in the ilium, and when we see imaging manifestations like this case, we should think it may be SFT.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang Province
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Jinsheng Liao
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Ryan Justin Choo
- Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Juncheng Yan
- Department of Radiology, the Fourth Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Jingfeng Zhang
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, China
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Spinal Solitary Fibrous Tumor/Hemangiopericytoma: A Clinicopathologic and Radiologic Analysis of Eleven Cases. World Neurosurg 2017; 104:318-329. [DOI: 10.1016/j.wneu.2017.05.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 12/20/2022]
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Albert GW, Gokden M. Solitary fibrous tumors of the spine: a pediatric case report with a comprehensive review of the literature. J Neurosurg Pediatr 2017; 19:339-348. [PMID: 28106515 DOI: 10.3171/2016.10.peds16279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Solitary fibrous tumors of the spine are rare lesions. Their description in the literature is limited to case reports and small case series. While generally benign lesions, they can recur and occasionally occur as malignancies. Here the authors present the case of a 10-year-old boy, the youngest patient and first preadolescent reported thus far, with this condition. In addition, they perform a comprehensive review of all previously published cases of spinal solitary fibrous tumors.
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Affiliation(s)
- Gregory W Albert
- Division of Neurosurgery, Arkansas Children's Hospital; and.,Departments of 2 Neurosurgery and
| | - Murat Gokden
- Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Rhee SJ, Ryu JK, Han SA, Won KY. Solitary fibrous tumor of the breast: a case report and review of the literature. J Med Ultrason (2001) 2015; 43:125-8. [PMID: 26703178 DOI: 10.1007/s10396-015-0674-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/06/2015] [Indexed: 11/26/2022]
Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that can be benign or malignant. SFTs have been most often documented in the pleura. Recently, involvement of extrapleural sites such as the abdomen, musculoskeletal soft tissue, upper respiratory tract, mediastinum, and head and neck were reported. Less than 15 cases of SFT of the breast have been reported. Here, we report a case of a pathologically proven SFT of the breast and review the literature on the radiologic findings. US imaging showed an oval, well-circumscribed, hypoechoic solid mass. A solitary fibrous tumor of the breast is a very rare lesion.
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Affiliation(s)
- Sun Jung Rhee
- Department of Radiology, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea
| | - Jung Kyu Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea.
| | - Sang-Ah Han
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Kyu Yeoun Won
- Department of Pathology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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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.
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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
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