- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Lombardia, Italy,
- Clinic for Forensics, University Psychiatric Clinic Basel, Basel, Switzerland,
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy,
- Department of Spinal Surgery and Spinal Cord Surgery, Swiss Paraplegic Centre, Notwill, Switzerland,
- Department of Neurosurgery, IRCCS Istituto Ortopedico Galeazzi, Milan,
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy.
Andrea Ciuffi, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Lombardia, Italy.
DOI:10.25259/SNI_538_2022Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Andrea Ciuffi1, Christian Saleh2, Maria Rosa Terreni3, Phillip Jaszczuk4, Edvin Zekaj5, Claudia Menghetti5, Andrea Franzini6, Domenico Servello5. A cervical solitary fibrous tumor with intramedullary invasion. 05-Aug-2022;13:343
How to cite this URL: Andrea Ciuffi1, Christian Saleh2, Maria Rosa Terreni3, Phillip Jaszczuk4, Edvin Zekaj5, Claudia Menghetti5, Andrea Franzini6, Domenico Servello5. A cervical solitary fibrous tumor with intramedullary invasion. 05-Aug-2022;13:343. Available from: https://surgicalneurologyint.com/surgicalint-articles/11763/
Solitary fibrous tumor is a tumor originating from the mesenchymal cells, which occurrence in the central nervous system is extremely rare and was described in few patients as to yet. We report on a 53-years old male patient presenting with right upper limb radicular pain and ipsilateral limbs paresis, who was diagnosed with a cervical spinal lesion which, after surgical resection, resulted to be a solitary fibrous tumor (SFT). We discuss imaging, clinical and histopathological findings to allow considering this tumor early in the differential diagnosis.
Keywords: Solitary fibrous tumor, Intramedullary spine tumor, Spinal cord compression
Solitary fibrous tumor is usually a benign neoplasm originating from mesenchymal cells, historically associated with the pleura. Its occurrence in the central nervous system is extremely rare.[
Clinical and imaging findings of SFT are not specific and it is considered a great mimicker,[
The proper and early diagnosis is crucial due to the higher propensity to both local as well as distant recurrences compared to similar pathologies like meningiomas.
We describe a 53-year-old male patient presenting with the right upper limb radicular pain and ipsilateral limb paresis. MRI of the cervical spine revealed a large spinal mass at the level of the sixth and seventh cervical vertebral bodies. The lesion appeared isointense on T1-weighted sequences and hypointense on T2-weighted images and was homogeneously contrasted by gadolinium [
The initial suspected diagnosis was that of a meningioma, and surgical resection through a laminectomy was planned. Intraoperatively, the lesion appeared gray-whitish and was present within the intramedullary space without a clear cleavage plane with the spinal cord [
The surgical procedure was uneventful and complete resection was achieved. Postoperatively, the patient presented with gait ataxia that completely recovered over time with the help of intensive physical rehabilitation.
Histological analysis revealed the main diagnostic characteristics of SFT: presence of cells organized into fascicles and hypocellular areas with fibrous stroma, immunoreactivity for CD34 and bcl-2, evidence of nuclear expression of STAT6, and the absence of mitosis or necrosis [
MRI alone cannot reliably distinguish SFT from other intradural tumors such as meningioma, schwannoma, astrocytoma, and ependymoma.[
During surgery, the mass typically shows a hard consistence and poor vascularization.[
Imaging is not helpful in predicting the grade of malignancy.[
Treatment of SFT consists of total surgical excision. Radiotherapy and chemotherapy are suggested in cases of incomplete resection.[
The authors certify that they have obtained all appropriate patient consent.
There are no conflicts of interest.
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