Ekkehard Kasper, Scott Boruchow, Fred C. Lam, Pascal O. Zinn, Matthew Anderson, Anand Mahadevan
  1. Division of Neurosurgery, Beth Israel Deaconess Medical Centre, Harvard University, Boston, Massachusetts, USA
  2. Department of Neurology, Beth Israel Deaconess Medical Centre, Harvard University, Boston, Massachusetts, USA
  3. Department of Radiation Oncolog, Beth Israel Deaconess Medical Centre, Harvard University, Boston, Massachusetts, USA

Correspondence Address:
Ekkehard Kasper
Department of Radiation Oncolog, Beth Israel Deaconess Medical Centre, Harvard University, Boston, Massachusetts, USA


Copyright: © 2012 Kasper E. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

How to cite this article: Kasper E, Boruchow S, Lam FC, Zinn PO, Anderson M, Mahadevan A. “Hitting all the right markers to save a life” Solitary fibrous tumors of the central nervous system: Case series and review of the literature. Surg Neurol Int 28-Jul-2012;3:83

How to cite this URL: Kasper E, Boruchow S, Lam FC, Zinn PO, Anderson M, Mahadevan A. “Hitting all the right markers to save a life” Solitary fibrous tumors of the central nervous system: Case series and review of the literature. Surg Neurol Int 28-Jul-2012;3:83. Available from:

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Background:Solitary fibrous tumors (SFTs) of the central nervous system are uncommon. Their biological features remain largely unknown; hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data. For this reason, we present two cases of large SFTs to illustrate a comprehensive review.

Methods:This was a retrospective analysis of two patients: a 65-year-old male with a left parietooccipital lesion and a 70-year-old female with a right parietal convexity mass.

Results:Gross total resection was performed in the male patient with no recurrence 30 months after resection. The second patient received stereotactic radiosurgery for what was initially thought to be a parafalcine meningioma; however, continued growth 1 year later prompted an open resection, with pathology indicative of an SFT. The tumor recurred the following year requiring repeat resection. Unfortunately, due to the aggressive nature of the lesion, the patient eventually succumbed to tumor burden a year later.

Conclusion:Based on the literature review, the sometimes observed aggressive growth pattern, and also, the potential for malignant transformation, we recommend complete resection of SFTs with close sequential follow-up.

Keywords: Solitary fibrous tumor, menigeoma, immunohistochemistry, pathology, treatment


Solitary fibrous tumors (SFTs) are uncommon spindle cell tumors of mesenchymal origin, and were initially described as primary neoplasms of the mediastinum and visceral pleura.[ 36 ] The tumorigenesis remained debatable, and later, the tumor entity was carefully reexamined and further characterized as fascicles of spindle cells, resembling CD34-positive interstitial dendritic cells intermingled with bands of collagen.[ 8 18 22 74 ] There have been more than 800 cases of pleural SFTs described in the literature with a peak incidence in the sixth and seventh decades of life found equally frequent among men and women[ 19 ] or with a slight preponderance among the female population.[ 72 ] However, they have also been reported under various other labels[ 14 ] in a large number of extrathoracic body sites, including head and neck, pericardium, peritoneum, liver, thyroid, mesentery, as well as the sinus and orbit[ 17 21 25 28 61 74 80 81 ] but only rarely in the central nervous system.


SFTs of the central nervous system (CNS) were first classified as a distinct pathological entity in 1996[ 11 ] and are categorized as a rare mesenchymal, nonmeningothelial tumor of the CNS. To date, fewer than 100 SFTs have been reported in the cranial and spinal compartments[ 9 12 13 15 20 82 ] and the fact that this tumor is different from other benign and malignant spindle cell tumor entities remains largely unknown to most neurosurgeons.[ 30 ]

SFTs in the CNS are most often dura-based neoplasms and can occur in any location, with reports in the supratentorium,[ 66 67 71 ] parenchyma,[ 13 ] sella,[ 23 ] ventricle,[ 6 16 37 69 75 ] cerebellopontine angle,[ 5 ] orbit/paranasal sinuses,[ 78 80 ] tentorium,[ 65 ] posterior fossa meninges,[ 27 64 ] along cranial nerves V[ 48 ] and VI,[ 77 ] at the foramen of Monroi,[ 35 ] and in the infratemporal fossa.[ 62 68 ] There is a tendency to manifest in the posterior fossa and spine as well as along spinal nerve rootlets.[ 2 5 7 12 31 32 38 41 56 58 60 76 ]

It is of interest that most intracranial SFTs seem to be dura-based, whereas two-thirds of spinal SFTs lack a dural attachment.[ 42 47 54 ] They represent an entity that is clinically distinct from other mesenchymal extracranial soft tissue tumors,[ 3 11 73 ] often leading to an unusual clinicopathological presentation and outcome pattern.[ 1 23 34 55 75 ] Both benign and aggressive forms have been described, as well as a potential toward malignant transformation.[ 82 ] Intracranial SFTs occur across all ages, with one recent review of 60 cases reporting an age range of 11–73 years, the majority being meningeal with near equal gender distribution and the median age of occurrence of 47.6 years.[ 12 ]


Based on standard CT and MR imaging (MRI) sequences, SFTs appear as heterogenous, hyperattenuated masses compared to adjacent brain parenchyma on noncontrast CT studies resembling meningiomas or hemangiopericytomas, with the possible erosion of the overlying skull but usually with a sharp demarcation toward the surrounding parenchyma and vivid contrast enhancement.[ 48 ] Resemblance to meningiomas and hemangiopericytomas also holds true intraoperatively.[ 4 39 ] SFTs are isointense on T1-weighted and mixed to low signal intensity on T2-weighted images with marked heterogenous enhancement.[ 16 40 79 ] They demonstrate restricted diffusion with an elevated peak of myoinositol on PET imaging.[ 16 ]


Histological features of SFTs include monomorphic spindle cells arranged in a patternless architecture or arranged in straight, curving, or undulating fascicles; prominent collagenous bands; branching vascular channels with thin walls; lack of other architectural features such as well-formed lobules, whorls, or psammoma bodies, which help to distinguish SFTs from meningiomas.[ 11 44 57 ]


Although outcome data are very limited, the extent of resection seems to be the most important prognostic factor.[ 45 73 ] Invasion or delayed seeding of the CSF space can occur even in the setting of seemingly benign SFTs.

To raise the awareness of challenges posed to the neurosurgeon in managing this distinct tumor entity, we present two representative cases of large SFTs and discuss their imaging and histological findings, and also, review the literature in regard to treatment and prognosis.


Case 1 – 65-year-old male with a left parietooccipital lesion

This patient presented to our clinic in October 2009 with visual disturbances and word-finding difficulties for several months. Physical exam revealed a right homonymous hemianopsia.

Preoperative imaging

MRI showed a multilobulated, heterogeneous contrast-enhancing lesion in the left parietooccipital lobe measuring 4 cm in diameter [ Figure 1a ] abutting the superior aspect of the tentorium [Figure 1b and c ]. The mass appeared to be predominantly within the occipital horn of the left lateral ventricle [ Figure 1d ]; however, we felt that there was also the possibility that the lesion was dura based and simply compressing the ventricle. Given the imaging characteristics, a provisional diagnosis of a meningioma was made.

Figure 1

Preoperative MRI of a solitary fibrous tumor involving the occipital horn of the left lateral ventricle also infiltrating the superior aspect of the tentorium cerebelli. (a) Axial, (b) sagittal, and (c) coronal T1-weighted imaging shows a multifocal tumor with uniform gadolinium enhancement. (d) The tumor is seen to invade the left occipital horn on T2-weighted imaging



The patient was counseled extensively and given the size, localization, and symptomatic nature of the lesion, surgery was recommended. An image-guided, left-sided parietooccipital craniotomy was performed with intraoperative histopathology suggestive of an aggressive malignant neoplasm in keeping with a malignant meningioma, ependymoma, or sarcoma. A gross total resection (GTR) was achieved with the removal of the intraventricular portions of the lesion along with its attachments to the choroid plexus, as well as complete resection of the inferior aspect abutting the tentorium.


Final histology revealed a solid tumor which composed of a dense population of spindle cells with thick fascicles of collagen and scattered infrequent vasculature [ Figure 2a ]. The trichrome stain confirmed the dense collagenous background [ Figure 2b ] with dense CD34 and BCL-2 but patchy Desmin staining [Figure 2c and d ], respectively. The tumor was negative for EMA, S-100, and HMB-45, thus ruling out a meningioma [Figure 2e and f ]. The MIB-1 index came back as 3%–5% of tumor cells [ Figure 2g ]. The microvasculature was positive for CD-31 but not in the tumor cells proper (results not shown). Factor XIIIa was negative. The staining pattern was consistent with that of a solitary fibrous tumor. This was corroborated on electron microscopy showing tumor cells abundant with rough endoplasmic reticulum [ Figure 2h , arrow] surrounded by dense parallel collagen fibrils [ Figure 2h , asterisk].

Figure 2

Histology of a solitary fibrous tumor. (a) H and E staining demonstrates a dense fibrous background with spindle-like cells. (b) Trichrome stain brings out the collagenous background. (c) Microvasculature is CD34 positive but in the tumor cells, (d) desmin shows patchy positivity. Cells are negative for (e) EMA and (f) S-100 and HMB-45 with (g) a moderate MIB-1 index of 3%–5%. (h) Electron microscopy shows abundance of rough endoplasmic reticulum (arrow) surrounded by dense collagen fibrils (*). No basement membrane is visible


Clinical outcome

The patient tolerated the surgery well and had no new focal deficits. As we were confident that we had achieved a GTR and the patient remained seizure free with no new symptoms, he chose not to pursue adjuvant radiotherapy and opted for expectant management. Repeat imaging at 30 months demonstrated no evidence of disease recurrence [ Figure 3 ].

Figure 3

Postoperative imaging at 2 years following a gross total resection shows absence of disease recurrence. (a) Axial, (b) sagittal, and (c) coronal T1-weighted postcontrast scans as along with (d) axial T2-weighted imaging show no tumor recurrence


Case 2 – 70-year-old female with a right parietal convexity lesion

This patient presented initially in 2004 with a several-year history of headaches, intermittent double vision, and occasional numbness and weakness in her left leg leading to multiple falls. Her exam was significant for horizontal diplopia, and bilateral decreased sensation to pinprick and vibration in a glove-stocking distribution.

Initial imaging

MRI of the brain showed a uniformly enhancing parafalcine lesion with a predominantly right-sided component with no associated peritumoral edema [Figure 4a and b ],suggestive of a meningioma.

Figure 4

Parafalcine convexity SFT in a 70-year-old female with malignant transformation following a course of radiotherapy. All images are T1-weighted postcontrast scans. A large, enhancing parafalcine dura-based lesion without surrounding edema seen on (a) axial and (b) coronal slices, initially thought to be a slow-growing meningioma, treated with a total radiotherapy dose of 3000 cGy. (c and d) Tumor enlargement despite radiotherapy. Postoperative imaging shows subtotal resection with residual tumor left attached to the superior sagittal sinus (e and f). Tumor recurrence 1 year following initial resection predominantly on the left side of the falx (g and h). Repeat resection shows adequate decompression with some left-sided residual tumor (i and j). Malignant transformation with recurrence on both sides of the falx 1 year following repeat resection (k and l)


Initial management

Given the assumption that this was a slow-growing meningioma of the falx with partial occlusion of the sinus compounded with risks of perioperative morbidity and impairment, the patient opted for stereotactic CyberKnife radiosurgery in November 2005, receiving five fractions of 600 cGy each for a total of 3000 cGy to the 84% idodose line. The patient was initially maintained on dexamethasone but was weaned off in February 2006 due to weakness from steroid myopathy. By April 2006, she was still having persistent bilateral leg weakness, left worse than right. Repeat MRI of the brain showed further enlargement of the mass with peritumoral edema despite radiotherapy [Figure 4c and d ]. Given the lack of response to radiation and worsening of the neurologic function, the patient consented to surgical resection, receiving a bifrontal craniotomy with a wide excision of the dura, leaving only parts that had infiltrated the superior sagittal sinus and convexity veins [Figure 4e and f ].


Staining of the specimen showed a solid tumor with prominent nucleoli, sheeting, and nuclear pleomorphism. Immunoperoxidase stains showed no reactivity to AE1, AE3, CAM5.2, or CD34, thus excluding metastasis, meningioma, and SFT. EMA staining was only focally and very weakly positive. The initial diagnosis was an atypical meningioma; however, dispersed among the tumor were features consistent with a spindle cell neoplasm such as SFT, interrupted by areas resembling transitional meningioma-type histology. Because the tumor had previously been treated with radiation, it was felt that it could no longer be graded by formal WHO criteria.

Clinical course

The patient returned in October 2007 with a sudden onset of right-sided weakness as well as increasing frequency of seizures. A repeat MRI revealed an enlarging recurrent tumor on the left side posterior to the resection bed and abutting the falx, causing a significant mass effect as well as edema [Figure 4g and h ]. The patient consented for a second resection and underwent a bifrontal redo craniotomy with image guidance for resection. She tolerated the procedure well with no complications and had a good surgical result [Figure 4i and j ].


Tissue examination of this recurrent tumor revealed dense bands of thick collagen interspersed with fascicles of spindle cells. Immunohistochemistry revealed positive staining with CD34 in regions of increased cellularity. EMA and cytokeratin cocktail showed high-background staining in brain tissue. GFAP, S100, and synaptophysin highlighted areas of entrapped and infiltrated brain parenchyma. MIB-1 revealed many proliferating cells, but LCA and CD68 revealed extensive infiltration of the tumor with lymphocytes and macrophages which likely accounted for the majority of proliferating cells. Actin highlighted smooth muscles in vessels, but was largely negative in the tumor. Trichrome stain revealed extensive collagen deposition. Reticulin stain revealed a fine network of reticulin outlining all neoplastic cells. These findings were diagnostic for a solitary fibrous tumor. Additional findings of cellular atypia in the neoplastic spindle cell population with features of brain invasion suggested malignant sarcomatous transformation of the tumor.

Postoperative course

In follow-up, the patient was seen to have improved strength in her right leg and decreased frequency of her seizures. She was able to stand and be mobilized again and was transferred to rehabilitation. Postoperative imaging demonstrated an adequate repeat resection [Figure 4i and j ]. Unfortunately, she presented in April 2008 again with progressive weakness and lethargy. MRI at this time showed bilateral parafalcine masses at the site of surgical resection, consistent with a recurring tumor [Figure 4k and l ]. The patient and her family were resistant to the idea of having repeat surgery or further radio- or chemotherapy and the decision was made to provide palliative care for the patient, who expired a few months later in a nursing facility.


SFTs bear clinical and radiographical resemblance to both fibrous meningiomas and hemangiopericytomas. They therefore require diligent work-up to reveal all histological and immunohistochemical features to distinguish between these rare but distinct CNS tumors and possible differentials.[ 9 11 24 29 33 73 81 ] Immunohistochemically, SFTs are in most cases diffusely positive for CD34,[ 57 74 80 ] while meningiomas are typically reactive for EMA. However, CD34 is not specific for SFTs, as weak and usually patchy staining may be visualized in meningiomas, neurofibromas, and hemangiopericytomas.[ 17 42 70 ] Positivity for CD99 and bcl-2 is found in more than half of all cases of SFTs[ 26 44 ] and they also stain strongly with the intermediate filament vimentin, but are usually negative for the neural crest markers S-100, GFAP, EMA, cytokeratin, or vascular antigens.[ 43 ] Chromosomal imbalances have been investigated via comparative genomic hybridization, and multiple sites of allelic losses and gains were identified, but no single pathognomonic underlying feature has been found thus far. Electron microscopy has not yielded a unique distinctive feature, but some typical aspects include a well-developed rough endoplasmatic reticulum, occasional primitive junctions, and a lack of desmosomes as well as basal lamina. For these reasons, immunocytochemistry is essential in making the primary diagnosis, when a complex differential diagnosis is entertained.

Treatment and outcomes

Although an infrequently encountered tumor entity, it is important to raise awareness of SFTs in neurosurgeons and neuro-oncologists alike as a distinct entity in the differential diagnosis of CNS tumors. In principle, SFTs should be carefully considered in suspicious cases when entertaining other benign differential diagnoses, including hemangiopericytomas, fibrous meningiomas, schwannomas, neurofibromas, and less favorable entities such as fibrosarcomas.[ 10 12 39 52 53 ]

The prognosis of SFTs remains yet to be fully elucidated since follow-up data of the few reported cases are limited, however, it is believed that these tumors generally pursue a slow, indolent, and nonaggressive course. As is illustrated in our first case, surgery offers the best first-line treatment and achieves excellent local control.[ 45 ] Recurrence (as in our second case), malignant transformation,[ 49 ] or cerebrospinal fluid dissemination has also been described, though seemingly not as frequently.[ 12 44 46 51 54 59 ]

The only 2 available larger series of 18 cases each of solitary fibrous tumors in the central nervous system[ 45 73 ] were carefully analyzed and in the first study, the reported 5-year survival rate was 100%, with only 3 of the 18 tumors recurring during the follow-up period[ 73 ] – as could be observed in our second case illustration. This differs slightly from the second series in which the median follow-up was only 45 months.[ 45 ] Here, 15 of 18 patients were alive at the time of the report, but a significantly higher portion (50%) had suffered a recurrence that required further treatment in 9 patients. Only one of the SFTs in the first above-mentioned review revealed anaplastic histological features and the significance of this is still unclear.[ 73 ] A GTR has been possible for most CNS SFTs reported in the literature and it appears that surgery alone is the appropriate initial management for most SFTs.[ 12 45 ] In these cases, meticulous and complete resection, rather than histological grading, is believed to be the most important prognostic factor and may preclude downstream malignant behavior.[ 42 ]

Conventional radiotherapy as well as stereotactic radiosurgery (SRS) has been described in occasional reports as adjuvant treatment for residual SFTs.[ 50 ] However, the role of adjuvant postoperative radiotherapy in improving long-term prognosis remains unclear and the number of patients who underwent complementary chemotherapy treatment is too small to evaluate any possible benefit.[ 45 ] A recent study was published recently reporting two cases that yielded reasonable treatment outcomes using Gamma Knife radiosurgery (GKRS) in patients who had recurrence of their intracranial SFTs following subtotal resection.[ 63 ] In the first case, the patient was referred for GKRS following a subtotal resection for recurrence with stable shrinking of the tumor at 20 months after treatment. The second case presented with multiple tumors that recurred following seven surgeries in the posterior fossa. Initial treatment with GKRS demonstrated effective local tumor control at 13 months; however, an out-of-field recurrence prompted repeat treatment at 15 months. This novel case series suggests that GKRS is a feasible adjunct for treating SFT; however, we still recommend close and indefinite follow-up for all patients.


SFTs of the CNS are rare entities that are challenging to manage. Higher powered prospective studies are needed to delineate the best management options, to further characterize the benefits of additional radio/chemotherapies, and also define the necessary duration of follow-up imaging in this patient population. Since the potential for malignant transformation exists, we recommend diligent long-term follow-up including regular imaging surveillance.


1. Ahn JY, Shim JY, Yang WI, Kim TS. Meningeal solitary fibrous tumor as an unusual cause of expohthalmos: Case report and review of the literature. Neurosurgery. 2001. 48: 1362-6

2. Alston SR, Francel PC, Jane JA. Solitary fibrous tumor of the spinal cord. Am J Surg Pathol. 1997. 21: 477-83

3. Ambrosini-Spaltro A, Eusebi V. Meningeal hemangiopericytomas and hemangiopericytoma/solitary fibrous tumors of extracranial soft tissues: A comparison. Virchows Arch. 2010. 456: 343-54

4. Barron J, Lownie SP, Lee DH, Hammond RR. June 2001: 61 year old woman with confusion and obtundation. Brain Pathol. 2001. 11: 485-6

5. Bikmaz K, Cosar M, Kurtkaya-Yapicier O, Iplikcioglu AC, Gokduman CA. Recurrent solitary fibrous tumour in the cerebellopontine angle. J Clin Neurosci. 2005. 12: 829-32

6. Boada M, Gomez E, Puig J, Pedraza S. Intraventricular fibrous tumor: A case report. Radiologia. 2009. 51: 512-5

7. Bohinski RJ, Mendel E, Aldape KD, Rhines LD. Intramedullary and extramedullary solitary fibrous tumor of the cervical spine. Case report and review of the literature. J Neurosurg. 2004. 100: S358-63

8. Briselli M, Mark EJ, Dickersin GR. Solitary fibrous tumors of the pleura: Eight new cases and review of 360 cases in the literature. Cancer. 1981. 47: 2678-89

9. Brunori A, Cerasoli S, Donati R, Giangaspero F, Chiappetta F. Solitary fibrous tumor of the meninges: two new cases and review of the literature. Surg Neurol. 1999. 51: 636-40

10. Cai N, Kahn LB. A report of primary brain fibrosarcoma with literature review. J Neurooncol. 2004. 68: 161-7

11. Carneiro SS, Scheithauer BW, Nascimento AG, Hirose T, Davis DH. Solitary fibrous tumor of the meninges: A lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study. Am J Clin Pathol. 1996. 106: 217-24

12. Caroli E, Salvati M, Orlando ER, Lenzi J, Santoro A, Giangaspero F. Solitary fibrous tumors of the meninges: Report of four cases and literature review. Neurosurg Rev. 2004. 27: 246-51

13. Centeno RS, Pedroso AA, Pereira EM, Rassi Neto A. Solitary fibrous tumor of the meninges: Case report. Arq Neuropsiquiatr. 2002. 60: 314-8

14. Chan JK. Solitary fibrous tumour--everywhere, and a diagnosis in vogue. Histopathology. 1997. 31: 568-76

15. Ciappetta P, D’Urso PI, Cimmino A, Ingravallo G, Rossi R, Colamaria A. Intramedullary solitary fibrous tumor of dorsal spinal cord. Neuropathology. 2010. 30: 273-8

16. Clarencon F, Bonneville F, Rousseau A, Galanaud D, Kujas M, Naggara O. Intracranial solitary fibrous tumor: Imaging findings. Eur J Radiol. 2011. 80: 387-94

17. Cox DP, Daniels T, Jordan RC. Solitary fibrous tumor of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010. 110: 79-84

18. Dalton WT, Zolliker AS, McCaughey WT, Jacques J, Kannerstein M. Localized primary tumors of the pleura: An analysis of 40 cases. Cancer. 1979. 44: 1465-75

19. de Perrot M, Fischer S, Brundler MA, Sekine Y, Keshavjee S. Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002. 74: 285-93

20. Donnellan RB, Govender D, Chite SH, Landers AT. An unusual presentation of solitary fibrous tumor. Spine (Phila Pa 1976). 2000. 25: 749-51

21. Dorfman DM, To K, Dickersin GR, Rosenberg AE, Pilch BZ. Solitary fibrous tumor of the orbit. Am J Surg Pathol. 1994. 18: 281-7

22. England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol. 1989. 13: 640-58

23. Furlanetto TW, Pinheiro CF, Oppitz PP, de Alencastro LC, Asa SL. Solitary fibrous tumor of the sella mimicking pituitary adenoma: An uncommon tumor in a rare location-a case report. Endocr Pathol. 2009. 20: 56-61

24. Gengler C, Guillou L. Solitary fibrous tumour and haemangiopericytoma: Evolution of a concept. Histopathology. 2006. 48: 63-74

25. Goodlad JR, Fletcher CD. Solitary fibrous tumour arising at unusual sites: Analysis of a series. Histopathology. 1991. 19: 515-22

26. Graadt van Roggena JF, Hogendoorn PC. Solitary fibrous tumour: The emerging clinicopathologic spectrum of an entity and its differential diagnosis. Curr Diagn Pathol. 2004. 10: 229-35

27. Hakan T, Turk CC, Aker FV. Tentorial solitary fibrous tumour: Case report and review of the literature. Neurol Neurochir Pol. 2009. 43: 77-82

28. Hasegawa T, Matsuno Y, Shimoda T, Hasegawa F, Sano T, Hirohashi S. Extrathoracic solitary fibrous tumors: Their histological variability and potentially aggressive behavior. Hum Pathol. 1999. 30: 1464-73

29. Hayashi Y, Uchiyama N, Nakada M, Iwato M, Kita D, Higashi R. A reevaluation of the primary diagnosis of hemangiopericytoma and the clinical importance of differential diagnosis from solitary fibrous tumor of the central nervous system. Clin Neurol Neurosurg. 2009. 111: 34-8

30. Hu SW, Tsai KB, Yang SF, Lee KS, Chai CY. Unusual solitary fibrous tumors in the central nervous system: A report of two cases. Kaohsiung J Med Sci. 2005. 21: 179-84

31. Kataoka H, Akiyama Y, Kubo S, Itoh H, Hamasuna R, Tajima N. Solitary fibrous tumor of the spinal nerve rootlet: Case report and literature survey. Pathol Int. 1999. 49: 826-30

32. Kawamura M, Izawa K, Hosono N, Hirano H. Solitary fibrous tumor of the spinal cord: Case report and review of the literature. Neurosurgery. 2004. 55: 433-

33. Kim DS, Kim TS, Choi JU. Intradural extramedullary xanthoma of the spine: A rare lesion arising from the dura mater of the spine: Case report. Neurosurgery. 1996. 39: 182-5

34. Kim KA, Gonzalez I, McComb JG, Giannotta SL. Unusual presentations of cerebral solitary fibrous tumors: Report of four cases. Neurosurgery. 2004. 54: 1004-9

35. Kinfe TM, Tschan CA, Stan AC, Krauss JK. Solitary fibrous tumor of the foramen of Monro. Clin Neurol Neurosurg. 2008. 110: 404-7

36. Klemperer P, Coleman BR. Primary neoplasms of the pleura. A report of five cases. Am J Ind Med. 1992. 22: 1-31

37. Kocak A, Cayli SR, Sarac K, Aydin NE. Intraventricular solitary fibrous tumor: An unusual tumor with radiological, ultrastructural, and immunohistochemical evaluation: Case report. Neurosurgery. 2004. 54: 213-6

38. Kurtkaya O, Elmaci I, Sav A, Pamir MN. Spinal solitary fibrous tumor: Seventh reported case and review of the literature. Spinal Cord. 2001. 39: 57-60

39. Lath R, Ranjan A, Gowrishankar S. Solitary fibrous tumor of the meninges. Neurol India. 2005. 53: 248-9

40. Lo CP, Chen CY, Lin CK, Chin SC, Juan CJ, Hsueh CJ. Parasellar solitary fibrous tumor of meninges: Magnetic resonance imaging features with pathologic correlation. J Neuroimaging. 2004. 14: 281-4

41. Malek AM, Weller SJ, Price DL, Madsen JR. Solitary fibrous tumor presenting as a symptomatic intraspinal mass: Case report. Neurosurgery. 1997. 40: 844-7

42. Martin AJ, Fisher C, Igbaseimokumo U, Jarosz JM, Dean AF. Solitary fibrous tumours of the meninges: Case series and literature review. J Neurooncol. 2001. 54: 57-69

43. Martin AJ, Summersgill BM, Fisher C, Shipley JM, Dean AF. Chromosomal imbalances in meningeal solitary fibrous tumors. Cancer Genet Cytogenet. 2002. 135: 160-4

44. Mekni A, Kourda J, Hammouda KB, Tangour M, Kchir N, Zitouna M. Solitary fibrous tumour of the central nervous system: Pathological study of eight cases and review of the literature. Pathology. 2009. 41: 649-54

45. Metellus P, Bouvier C, Guyotat J, Fuentes S, Jouvet A, Vasiljevic A. Solitary fibrous tumors of the central nervous system: Clinicopathological and therapeutic considerations of 18 cases. Neurosurgery. 2007. 60: 715-22

46. Miyashita K, Hayashi Y, Fujisawa H, Hasegawa M, Yamashita J. Recurrent intracranial solitary fibrous tumor with cerebrospinal fluid dissemination. Case report. J Neurosurg. 2004. 101: 1045-8

47. Mordani JP, Haq IU, Singh J. Solitary fibrous tumour of the spinal cord. Neuroradiology. 2000. 42: 679-81

48. Motoori K, Hanazawa T, Yamakami I, Sugimoto A, Ito H. Intra- and extracranial solitary fibrous tumor of the trigeminal nerve: CT and MR imaging appearance. AJNR Am J Neuroradiol. 2010. 31: 280-1

49. Munoz E, Prat A, Adamo B, Peralta S, Ramon y Cajal S, Valverde C. A rare case of malignant solitary fibrous tumor of the spinal cord. Spine (Phila Pa 1976). 2008. 33: E397-9

50. Nakahara K, Yamada M, Shimizu S, Fujii K. Stereotactic radiosurgery as adjuvant treatment for residual solitary fibrous tumor. Case report. J Neurosurg. 2006. 105: 775-6

51. Ng HK, Choi PC, Wong CW, To KF, Poon WS. Metastatic solitary fibrous tumor of the meninges. Case report. J Neurosurg. 2000. 93: 490-3

52. Nikas DC, De Girolami U, Folkerth RD, Bello L, Zamani AA, Black PM. Parasagittal solitary fibrous tumor of the meninges. Case report and review of the literature. Acta Neurochir (Wien). 1999. 141: 307-13

53. Nishio S, Fukui M. Solitary fibrous tumor in neurosurgical practice. Crit Rev Neurosurg. 1999. 9: 319-25

54. Ogawa T, Moriyama E, Beck H, Sonobe H. Solitary fibrous tumor of the thoracic spinal cord. Neurol Med Chir (Tokyo). 2005. 45: 371-4

55. Pakasa NM, Pasquier B, Chambonniere ML, Morrison AL, Khaddage A, Perret AG. 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. Virchows Arch. 2005. 447: 81-6

56. Perez-Nunez A, Rivas JJ, Ricoy JR, Miranda P, Arrese I, Lobato RD. Solitary fibrous tumor of the tentorium cerebelli. Case report. J Neurosurg Sci. 2004. 48: 59-62

57. Perry A, Scheithauer BW, Nascimento AG. The immunophenotypic spectrum of meningeal hemangiopericytoma: A comparison with fibrous meningioma and solitary fibrous tumor of meninges. Am J Surg Pathol. 1997. 21: 1354-60

58. Piana S, Putrino I, Cavazza A, Nigrisoli E. Solitary fibrous tumor of the spinal nerve rootlet: Report of a case mimicking schwannoma. Arch Pathol Lab Med. 2004. 128: 335-7

59. Pizem J, Matos B, Popovic M. Malignant intracranial solitary fibrous tumour with four recurrences over a 30-year period. Neuropathol Appl Neurobiol. 2004. 30: 696-701

60. Prayson RA, McMahon JT, Barnett GH. Solitary fibrous tumor of the meninges. Case report and review of the literature. J Neurosurg. 1997. 86: 1049-52

61. Ramdial PK, Nadvi S. An unusual cause of proptosis: Orbital solitary fibrous tumor: Case report. Neurosurgery. 1996. 38: 1040-3

62. Rayappa CS, McArthur PD, Gangopadhyay K, Antonius JI. Solitary fibrous tumour of the infratemporal fossa. J Laryngol Otol. 1996. 110: 594-7

63. Reames DL, Mohila CA, Sheehan JP. Treatment of intracranial solitary fibrous tumors with gamma knife radiosurgery: Report of two cases and review of literature. Neurosurgery. 2011. 69: E1023-8

64. Sanno N, Shimura T, Maeda S, Teramoto A. A case of solitary fibrous tumor of the meninges. Brain Tumor Pathol. 2001. 18: 43-7

65. Secer HI, Gonul E, Onguru O, Izci Y. Solitary fibrous tumour extending both supratentorially and infratentorially. J Clin Neurosci. 2008. 15: 830-3

66. Shidoh S, Yoshida K, Takahashi S, Mikami S, Mukai M, Kawase T. Parasagittal solitary fibrous tumor resembling hemangiopericytoma. Brain Tumor Pathol. 2010. 27: 35-8

67. Shimizu S, Oka H, Kawano N, Utsuki S, Suzuki S, Iwabuchi K. Solitary fibrous tumor arising from the falx cerebri-case report. Neurol Med Chir (Tokyo). 2000. 40: 650-4

68. Suhr M, Gottschalk J, Kreusch T. Metastatic malignant solitary fibrous tumour to the infra-temporal fossa. Int J Oral Maxillofac Surg. 2003. 32: 659-61

69. Surendrababu NR, Chacko G, Daniel RT, Chacko AG. Solitary fibrous tumor of the lateral ventricle: CT appearances and pathologic correlation with follow-up. AJNR Am J Neuroradiol. 2006. 27: 2135-6

70. Suzuki S, Wanifuchi H, Shimizu T, Kubo O. Hemangiopericytoma in the lateral ventricle. Neurol Med Chir (Tokyo). 2009. 49: 520-3

71. Teranishi K, Yamamoto T, Nakao Y, Osada H, Wada R, Mori K. Recurrent solitary fibrous tumor of the falx cerebri with intraventricular extension: Case report. Neurol Med Chir (Tokyo). 2007. 47: 269-72

72. Thorgeirsson T, Isaksson HJ, Hardardottir H, Alfredsson H, Gudbjartsson T. Solitary fibrous tumors of the pleura: An estimation of population incidence. Chest. 2010. 137: 1005-6

73. Tihan T, Viglione M, Rosenblum MK, Olivi A, Burger PC. Solitary fibrous tumors in the central nervous system. A clinicopathologic review of 18 cases and comparison to meningeal hemangiopericytomas. Arch Pathol Lab Med. 2003. 127: 432-9

74. van de Rijn M, Lombard CM, Rouse RV. Expression of CD34 by solitary fibrous tumors of the pleura, mediastinum, and lung. Am J Surg Pathol. 1994. 18: 814-20

75. Vassal F, Manet R, Forest F, Camdessanche JP, Peoc’h M, Nuti C. Solitary fibrous tumors of the central nervous system: Report of five cases with unusual clinicopathological and outcome patterns. Acta Neurochir (Wien). 2011. 153: 377-84

76. Vorster SJ, Prayson RA, Lee JH. Solitary fibrous tumor of the thoracic spine. Case report and review of the literature. J Neurosurg. 2000. 92: S217-20

77. Waldron JS, Tihan T, Parsa AT. Solitary fibrous tumor arising from Cranial Nerve VI in the prepontine cistern: Case report and review of a tumor subpopulation mimicking schwannoma. Neurosurgery. 2006. 59: E939-40

78. Welling LC, Lynch JC, Ferreira LA, Correa JB, Sapunaru M, Cortezzi W. Solitary fibrous tumor with intracranial invasion. Arq Neuropsiquiatr. 2009. 67: 701-3

79. Weon YC, Kim EY, Kim HJ, Byun HS, Park K, Kim JH. Intracranial solitary fibrous tumors: Imaging findings in 6 consecutive patients. AJNR Am J Neuroradiol. 2007. 28: 1466-9

80. Westra WH, Gerald WL, Rosai J. Solitary fibrous tumor. Consistent CD34 immunoreactivity and occurrence in the orbit. Am J Surg Pathol. 1994. 18: 992-8

81. Witkin GB, Rosai J. Solitary fibrous tumor of the upper respiratory tract. A report of six cases. Am J Surg Pathol. 1991. 15: 842-8

82. Zhang J, Cheng H, Qiao Q, Zhang JS, Wang YM, Fu X. Malignant solitary fibrous tumor arising from the pineal region: Case study and literature review. Neuropathology. 2010. 30: 294-8

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