Intracranial solitary fibrous tumors: A report of two cases and a review of the literature

Abstract

Abstract. Solitary fibrous tumors (SFTs) are uncommon, with the pleura as a site of predilection. Central nervous system SFTs, particularly intracranial SFTs, are extremely rare. The lesions are generally benign and localized, and surgery is the main therapeutic solution. The current study reports the cases of a patient who presented with right haunch pain, right leg weakness and paresthesias for several months, and a patient with a history of unexpected loss of consciousness. Magnetic resonance imaging revealed the presence of lesions, with a spindle cell morphology evident on pathological examination. The immunohistochemical examination demonstrated a strong immunoreaction for cluster of differentiation 34, which supported the diagnosis of an SFT. Following a near-total resection, the patients had a good neural prognosis. The present study also provides a literature review, discussing the imageological and pathological characteristics of SFT, and the diagnostic methods that aid in distinguishing the entity from other spindle-cell central nervous system tumors.

Intracranial Solitary Fibrous Tumor

“…The tumour is further characterised by a positive CD34 stain and a positive STAT-6 stain [ 4 6 ]. Some authors also reported positive bcl-2 and vimentin staining in ISFTs [ 6 7 ]. Dedifferentiated SFT may be positive for p53, while the conventional, fibrous component is usually negative or shows scarcely scattered positive staining [ 4 ].…”

“…At MRI, a majority of cases are homogeneous on T1-weighted imaging (most often isointense). In literature, the most common presentation is a heterogeneous pattern on T2-weighted imaging with hypointense areas [ 1 7 ]. This may be explained by the existence of two separate components within the tumour.…”

“…The combination of these two components gives rise to the so-called yin yang sign, which is associated with ISFTs. Other reports [ 2 7 ] state that a hypointense or a hyperintense T2 signal is more common than a heterogeneous T2 signal, with heterogeneous contrast enhancement in most cases. In contrast to meningeomas, ISFTs rarely demonstrate contrast enhancement of the adjacent meninges (dural tail sign).…”

A solitary fibrous tumor with concurrent meningioma at the same site: A case report and review of the literature

“…Concurrence of intracranial SFTs and other tumor types is particularly rare, and SFTs are easily misdiagnosed due to a lack of typical symptoms and imaging features. By contrast, meningiomas, which arise from cells covering the arachnoid layer of the dura mater or from the intraventricular choroid plexus, present with a typical dural tail sign upon magnetic resonance imaging (MRI) ( 2 , 3 ). Histologically, both meningiomas and SFTs are composed of interlacing fascicles of spindle or ovoid tumor cells with intervening collagen bands.…”

A Case of Intracranial Solitary Fibrous Tumor

“…Its damage could be caused by compression on the adjacent structures or increased intracranial pressure. [4]…”