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

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.

Solitary fibrous tumor located in the sella turcica: A report of two cases and review of the literature

“…In light of its rarity and considering that SFT may mimic other types of tumor located in the sellar and suprasellar area, SFT of the sella turcica is easily misdiagnosed prior to surgery. The six known SFT cases, including the four cases reported in the literature (6,(12)(13)(14) and the two cases reported in the present study, were initially diagnosed as pituitary macroadenomas. Among the six cases, three were male and three were female patients, with an age range of 20-66 years and an average age of 37 years.…”

“…In addition, cavernous sinuses were invaded in 3/6 cases, the carotid artery was encased in 3/6 cases, and the sphenoid and temporal bones were infiltrated in 1/6 cases. No pathognomonic findings were elucidated and sellar SFTs were demonstrated to share similar imaging characteristics with pituitary macroadenomas (6,12,13,16). Therefore, although the occurrence of SFT in the sellar turcica is rare, it should be considered during differential diagnosis.…”

“…However, a literature search of the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed), using the search term 'sella turcica solitary fibrous tumor' revealed that only four cases involving the sella turcica have been published in the English literature to date (6,(12)(13)(14) (Table I); thus, the sella turcica is a relatively uncommon site of SFT. In light of its rarity and considering that SFT may mimic other types of tumor located in the sellar and suprasellar area, SFT of the sella turcica is easily misdiagnosed prior to surgery.…”

“…SFTs rarely occur in the sella turcica, with only four cases of sellar SFT described in the literature thus far (6,(12)(13)(14) (Table I). SFTs can be easily misdiagnosed as they rarely occur and share similar radiological and clinical symptoms with other sella turcica tumors, including macroadenoma, meningioma and craniopharyngioma (6,12,14).…”

Hemorrhagic intramedullary solitary fibrous tumor of the conus medullaris: case report

“…6,21,34 Specifically, within the spine there have been 46 reported cases 1,4,5,7,8,[10][11][12][13][14][15][16][17][18][19][20]22,23,[25][26][27][28][29][30][31][32][33][35][36][37] in the literature since the first description in 1997. …”