Brain Tumor Res Treat.  2015 Oct;3(2):127-131. 10.14791/btrt.2015.3.2.127.

Solitary Fibrous Tumor of Central Nervous System: A Case Report

Affiliations
  • 1Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea. khyang@nhimc.or.kr
  • 2Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 3Department of Pathology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Abstract

Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin, especially in the central nervous system (CNS). Reported herein is a case of SFT of CNS in a 63-year-old female patient who had confused mentality, without other neurological deficit. The brain MRI showed an ovoid mass in the right frontal lobe. The tumor was surgically removed grossly and totally, and the pathologic diagnosis was SFT. At 55 months after the surgery, the tumor recurred at the primary site and at an adjacent area. A second operation was thus done, and the tumor was again surgically removed grossly and totally. The pathologic diagnosis was the same as the previous, but the Ki-67 index was elevated. Ten months later, two small recurring tumors in the right frontal skull base were found in the follow-up MRI. It was decided that radiation therapy be done, and MRI was done again 3 months later. In the follow-up MRI, the size of the recurring mass was found to have decreased, and the patient did not manifest any significant symptom. Follow-up will again be done 18 months after the second surgery.

Keyword

Solitary fibrous tumors; Central nervous system

MeSH Terms

Brain
Central Nervous System*
Diagnosis
Female
Follow-Up Studies
Frontal Lobe
Humans
Magnetic Resonance Imaging
Middle Aged
Skull Base
Solitary Fibrous Tumors*

Figure

  • Fig. 1 Preoperative image shows about 8.0×5.2×6.4 cm3 sized ovoid mass in the right frontal convexity. A: CT shows iso to high density with parenchyma. B: T1WI shows intermediate-low signal intensity. C: T2WI shows intermediate-low signal intensity and in upper and medial portion of this mass, there are lesions with relatively low signal intensity. D: Gd-enhanced T1WI shows relatively strong enhancement. Postoperative 55 months MRI shows recurrence of tumor. E: CT shows isodensity mass with around low density with parenchyma. F: T1WI shows intermediate-low signal intensity. G: T2WI shows intermediate-high signal intensity. H: Gd-enhanced T1WI shows relatively strong enhancement. After 10 months second surgery, MRI shows a few small recurred nodule in right frontal base. I: T1WI. J: Gd-enhanced T1WI shows small nodule (arrows) in right frontal base. K: T2WI. L: FLAIR. After 3 months IMRT, MRI shows decreased size of nodule. M: T1WI. N: Gd-enhanced T1WI. O: T2WI. P: FLAIR. T1WI, T1-weighted image; T2WI, T2-weighted image; FLAIR, fluid attenuated inversion recovery; IMRT, intensity-modulated radiation therapy.

  • Fig. 2 Immunohistochemical features of first operation. A: On histologic examination of lower power view, mixed hypercellular and hypocellular area are seen with multifocally laid down collagen and occasional staghorn-like vessels (H&E, ×100). B: On high power field, relatively homogenous short spindle tumor cells in intervening collagens are seen (H&E, ×400). C: Sparse reticulin fibers are observed among tumor cells contrary to hemangiopericytoma (reticulin stain, ×200). D: The tumor cells show diffuse strong reactivity for CD34 on immunohistochemical stain (CD34, ×400). H&E, hematoxylin and eosin.


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