NeoplasmSolitary fibrous tumor of the meninges: two new cases and review of the literature
Section snippets
Case 1
This 18-year-old male patient came to our attention reporting a 1-year history of left arm paresthesias, limb weakness, and urinary retention. Magnetic resonance imaging (MRI) disclosed a large (9 × 3 × 4.7 cm) transdural (intra-extradural) extramedullary tumor extending from the lower clivus down to C3, with predominant left posterolateral growth (Figure 1, left). The homogeneously enhancing mass displayed regular rounded margins and expansive-type growth without erosion of bony structures.
Case 2
A 46-year-old female presented with an 8-month history of left sciatalgia with no sphynteric disturbances. MRI disclosed an intradural-extramedullary spinal tumor localized at T12-L1 level (Figure 3). A T12-L1 laminectomy was performed and an intradural tumor was totally removed.
Macroscopically, the tumor presented as a well delimited, whitish nodule of 1.6 cm in maximum diameter, with a fasciculated cut surface. The postoperative course was uneventful and when the patient was discharged on
Histology
Both cases had similar histology and immunohistochemical profile. The tumors showed spindle cell proliferation with areas of collagenization and a rich vascular component, more abundant in Case 1 (Figure 2). No cellular whorls or psammoma bodies, except rare entrapped leptomeningeal ones, were observed (Figure 2). Minimal lymphoid infiltrate was present. The vascular network showed irregular vascular lumina with “hemangiopericytoma-like” pattern (Figure 4). Mitoses were rare (less than 1/10
Discussion
Solitary fibrous tumor (SFT) was first differentiated from diffuse mesothelioma in 1931 by Klemperer and Rabin [17]. Although challenged [25], their proposal of a mesenchymal rather than mesothelial origin of the tumor is nowdays generally accepted on the base of sound immunohistochemical, ultrastructural, and cell culture evidence 2, 9, 16, 30. SFT consists of monomorphous sheets of spindle cells in straight, gently curving or somewhat undulating fascicles embedded in a conspicuous fibrous
References (34)
- et al.
Immunohistochemical profile of meningiomas and their histological subtypes
Hum Pathol
(1990) - et al.
Expression of the CD34 gene in vascular endothelial cells
Blood
(1990) - et al.
Solitary fibrous tumorhistological and immunohistochemical spectrum of benign and malignant variants presenting at different sites
Hum Pathol
(1995) - et al.
Successful operation for solitary fibrous tumor of the epicardium
J Thorac Cardiovasc Surg
(1995) - et al.
Malignant fibrous histiocytoma arising from the meninges of the posterior fossa
Surg Neurol
(1986) - et al.
Solitary fibrous tumor of the spinal cord
Am J Surg Pathol
(1997) - et al.
Malignant fibrosarcomatous mesothelioma and benign pleural fibroma (localized fibrous mesothelioma) in tissue culture
Cancer
(1979) - et al.
Solitary fibrous tumor
Ann Otol Rhinol Laryngol
(1993) - et al.
CD34 positivity in solitary fibrous tumor of the liver
Am J Surg Pathol
(1995) - et al.
Solitary fibrous tumor of the thyroid
Am J Clin Pathol
(1994)
Solitary fibrous tumor of the meningesa lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study
Am J Clin Pathol
Solitary fibrous tumor of the orbit
Am J Surg Pathol
Localized fibrous tumor of the serosal cavitiesimmunohistochemical, electron-microscopic and flow-cytometric DNA study
Am J Clin Pathol
Localized benign and malignant fibrous tumors of the pleuraa clinicopathologic review of 223 cases
Am J Surg Pathol
Extrapleural solitary fibrous tumorA report of seven cases
Mod Pathol
Meningeal hemangioperycitomahistopathological features, treatment and long-term follow-up of 44 cases
Neurosurgery
Solitary fibrous tumor of the mesentery
Am J Gastroenterol
Cited by (68)
Solitary fibrous tumor of the middle cranial fossa: Literature review and case report
2022, Interdisciplinary Neurosurgery: Advanced Techniques and Case ManagementCitation Excerpt :Solitary fibrous tumor (SFT) is a rare pathological entity first described in the central nervous system by Carnerio et al in 1996 [1]. The involvement of the nervous system is rare (0,1% of all meningeal neoplasms) [2], likely because of the low content of true connective tissue elements. SFTs may involve both the intracranial [3–5] and spinal [1,6] compartments, including intraparenchymal, skull base and nerve root locations.
Primary intra and extradural solitary fibrous tumor/hemangiopericytoma of thoracic spine with paravertebral intrathoracic spread: Case report and review of the literature
2020, Interdisciplinary Neurosurgery: Advanced Techniques and Case ManagementMeningeal Neoplasms
2012, Imaging of the BrainEpithelioid solitary fibrous tumor of the central nervous system
2012, Clinical Neurology and NeurosurgeryCitation Excerpt :Solitary fibrous tumor (SFT) is an uncommon but distinctive mesenchymal neoplasm originally described as pleural lesion in 1931 [1], but later it has been recorded at almost every anatomic location [2–4]. So far fewer than 100 cases of central nervous system SFT have been documented since the first description of meningeal SFT was reported in 1996 by Carneiro et al [5–7]. Epithelioid morphology in SFT is extremely rare.
The central nervous system solitary fibrous tumor: A review of clinical, imaging and pathologic findings among all reported cases from 1996 to 2010
2011, Clinical Neurology and NeurosurgeryCitation Excerpt :Statistical analyses were performed with SPSS 16.0 (SPSS, Chicago, IL). The literature search identified 187 reported cases of CNS SFT in 102 published works from 1996 to 2010 [1–102], for a total of 189 cases including the two presented herein. The vast majority of articles were in English (91%).