Solitary fibrous tumor (SFT) or hemangiopericytoma (HPC) is a rare fibroblastic tumor of mesenchymal origin. SFT or HPC comprises <1% of all primary central nervous system tumors. SFT or HPC of the sellar or suprasellar region is even more unusual. We herein report a sellar SFT or HPC in an octogenarian who achieved favorable progress with partial removal followed by fractionated gamma knife radiosurgery. An 87-year-old woman presented with occasional headache and visual field defects. A rapidly growing tumor of the sella turcica was diagnosed. The patient underwent endoscopic transnasal transsphenoidal surgery; however, only partial resection of the tumor was possible, as it was fibrous and hard with increased vascularity. A histological examination confirmed the tumor to be grade II SFT or HPC. Two months after the resection, the residual tumor grew rapidly. Given the patient's advanced age, re-surgery was not the preferred option; thus, fractionated gamma knife radiosurgery (marginal dose, 30 Gy in five fractions) was performed. MRI and visual field examination performed 3 months after irradiation revealed tumor shrinkage and improvement in the visual field, respectively. One year and three months after irradiation, the tumor continued to shrink and her visual field had improved. Taking age into consideration, partial resection with fractionated gamma knife radiosurgery was the more appropriate choice for both local tumor control and the safety of the optic apparatus.

The free fatty acid receptor 1 (FFAR1) is suggested to function as a G protein-coupled receptor (GPR40) for medium-to-long-chain free fatty acids. Previous studies on the expression of FFAR1 revealed that the nigrostriatal region is one of the areas which express abundant FFAR1 mRNA/protein in the central nervous system (CNS). However, the role of FFAR1 in the CNS has been still largely unclarified. Here, we examined a possible functional role of FFAR1 in the control of extracellular concentrations of striatal monoamines and cocaine-induced locomotor activity. Microdialysis analysis revealed that the basal level of extracellular dopamine (DA) was significantly elevated, while the basal serotonin (5-HT) level tended to be reduced in the striatum of FFAR1 knockout (−/−) mice. Interestingly, local application of a FFAR1 agonist, GW9508, markedly augmented the striatal 5-HT release in FFAR1 wild-type (+/+) mice, whereas topical application of a FFAR1 antagonist, GW1100, significantly reduced the 5-HT release. However, the enhanced 5-HT release was completely lost in −/− mice. Although acute administration of cocaine enhanced the locomotor activity in both +/+ and −/− mice, the magnitude of the enhancement was significantly reduced in −/− mice. In addition, intraperitoneal injection of GW1100 significantly decreased the cocaine-induced locomotor enhancement. These results suggest that FFAR1 has a facilitatory role in striatal 5-HT release, and the evoked 5-HT release might contribute to enhance cocaine-induced locomotor activity.

Intracranial pial arteriovenous fistula (pAVF) is uncommon, accounting for approximately 1.6% of all intracranial vascular malformations. High flow pressure renders varices and AVF highly susceptible to rupture and life-threatening hemorrhage.A 15-year-old girl who presented with headache and visual disturbance was diagnosed with an intracranial pAVF associated with a giant varix in the right occipital lobe. Imaging studies showed anomalous dilatation of the right posterior cerebral artery, a 53 mm thrombosed and calcified varix in the right occipital lobe, and drainage into the transverse sinus. We planned a combined surgery with the goal of reducing the mass and curing the pAVF. The patient underwent coil embolization for the obliteration of an angiographic shunt point; however, shunt flow appeared from the new feeders. We resected the giant varix with an angiographic shunt point completely and safely, with embolization the following day. The patient was discharged without any postoperative intracranial complications. The pathological shunt point was confirmed.Recently, reports on endovascular surgery for pAVF have increased. Combined surgery that includes safe excision, particularly in cases with mass effects, is required.

Background: Solitary fibrous tumor/hemangiopericytomas (SFT/HPCs) are rare mesenchymal tumors of nonmeningothelial origin that comprises <1% of all central nervous system tumors. Case Description: A 45-year-old male presented with sleep apnea (apnea-hypopnea index was 17.1 events/hour) and dysesthesias of the right upper and lower extremities. The magnetic resonance demonstrated a heterogeneous intradural extra-axial C1 mass with syringobulbia and syringomyelia. The right vertebral angiography revealed a hypervascular mass (i.e., intense tumor staining). With the preoperative diagnosis of a spinal hemangioblastoma, the patient underwent tumor removal. However, intraoperative findings demonstrated that the ventral component of the tumor was intramedullary without a dural attachment. Further, the histological diagnosis was consistent with SFT/HPC (HPC phenotype). The postoperative course was uneventful, and the patient’s symptoms and the syrinxes spontaneously regressed. Conclusion: A 45-year-old male presented a rare spinal intradural lesion at C1 appeared to be a spinal hemangioblastoma, but proved to be SFT/HPC (HPC phenotype) with intramedullary invasion.