Angioarchitecture and Pre-Surgical Embolization of Central Nervous System Solitary Fibrous Tumor/Hemangiopericytoma

Cystic intracranial solitary fibrous tumor: a case report

Solitary fibrous tumor (SFT) is a rare spindle cell tumor originating from mesenchymal tissue, and even rarer when it occurs intracranially. This case report described a 42-year-old man who presented with headache and limb weakness for more than 10 days. Magnetic resonance imaging (MRI) showed a well-defined multicompartmental cystic space-occupying lesion in the left occipital region, with surrounding edema and a compressed left lateral ventricle, the mass growing across the cerebellar vermis, which was initially diagnosed as hemangioblastoma. Neurosurgery was utilized to successfully remove the mass, and intracranial solitary fibrous tumor (ISFT) was identified by postoperative pathological analysis. Here, this article describes the imaging manifestations and pathologic features of a case of cystic intracranial solitary fibrous tumor, aiming to improve the understanding and diagnosis of this disease in order to provide an accurate therapy plan.

Solitary fibrous tumor of the pineal region in the elderly: A case report

INTRODUCTION

Solitary fibrous tumor (SFT) is a mesenchymal tumor with spindle cells that is often detected in the subcutaneous area and rarely in the central nervous system. Intracranial SFTs rarely occur in individuals older than 80 years, and there are only a few cases reports involving the pineal region.

PRESENTATION OF CASE

The present case was an 80-year-old man with lightheadedness, headache, and vomiting. Magnetic resonance imaging showed a tumor in the pineal region extending along the falx and tentorium cerebelli with homogenous enhancement. Subtotal resection was performed via the occipital transtentorial approach. A histopathological examination showed the proliferation of oval- to spindle-shaped tumor cells with bland nuclei arranged in a haphazard pattern and accompanied by staghorn-like branching vessels. Immunohistochemically, tumor cells were positive for CD34 (focal), CD99, and STAT6, but negative for epithelial membrane antigen (EMA) and S-100. Based on these findings, the tumor was diagnosed as SFT (WHO grade I).

DISCUSSION

Although difficulties are associated with differentiating SFT from meningioma on imaging, recurrence and metastasis are more common with SFT than with meningioma; therefore, histological and immunohistochemical analyses are important. A correlation has been reported between postoperative adjuvant radiotherapy and longer progression-free survival; however, this needs to be confirmed in further studies.

CONCLUSION

SFT involving the pineal region is rare in the elderly, but needs to be considered as a preoperative diagnosis. Since high rates of postoperative recurrence and metastasis have been reported, long-term follow-ups are required after surgery.