Solitary fibrous tumor of the pineal region with delayed ectopic intracranial metastasis: A case report and review of the literature

Abstract

Rationale: Solitary fibrous tumors of central nervous system are rare spindle-cell mesenchymal tumors. Although most are benign in nature, malignant transformation and extracranial metastasis have been reported. Up to now, only one case of CSF dissemination was described. Here we described an extremely rare case of intracranial Solitary fibrous tumors arising from the pineal region with a delayed ectopic metastasis. Patient concerns: A 35-year-old female presented with double vision, memory disturbance and unsteady gait was referred to our center. MRI showed an irregular mass in the pineal region. Diagnoses: The patient was diagnosed as pineal tumor, with unknown pathology. Interventions: Gross total resection was achieved and the pathologic studies confirmed a solitary fibrous tumor. Thirty-nine months later local recurrence occurred and gamma-knife radiotherapy was offered. Seven months later, MRI found a metastasis in the left temporal lobe. Surgical resection was conducted and pathological analysis revealed changes in cell morphology, counts and Ki-67 level, confirmed the diagnosis of solitary fibrous tumor/hemangiopericytoma (WHO Grade III). The patient received post-operational radiotherapy. Outcomes: The patient was followed up for 7 months with no signs of recurrence. Lessons: Here, we report an extremely rare case of primary solitary fibrous tumor of pineal region with delayed intracranial ectopic metastasis, together with literature review of metastatic solitary fibrous tumors. Strict surveillance is strongly recommended, considering the malignant potential of this seemingly benign disease entity. Complete resection of the tumor is the treatment of first choice and radiotherapy might be an effective adjuvant therapy for high grade SFT/HPCs.

Solitary fibrous tumor of the pineal region in the elderly: A case report

“…CNS SFTs are most commonly located along the falx cerebri, occipital and spinal dura, tentorium cerebelli, and at the cerebellopontine angle, and often have an attachment to the meninges [4] . However, SFTs in the pineal region are rare, with only five cases, including the present case, being reported to date [3] .…”

“…Intracranial SFTs occur at a median age of 42.5 years, and rarely in individuals as old as 80 years [2] . CNS SFTs are most commonly located along the falx cerebri, occipital and spinal dura, tentorium cerebelli, and at the cerebellopontine angle, with only a few cases reports involving the pineal region [3] , [4] . We herein present a case of SFT in the pineal region of an 80-year-old man and review the literature.…”

Recurrent Solitary Fibrous Tumor in Intradural Extramedullary Space: Case Report and Review of the Literature

“…There are studies advocating that RT is not strictly indicated after complete resection due to close follow-up and low recurrence rate [4] and that adjuvant radiotherapy can be considered in the case of subtotal resection [26][27][28] or if we are facing a high grade SFT [29]. There are studies advocating adjuvant radiotherapy be standard of treatment [18,30].…”

A Rare Case of a Primary Leiomyoma of the Clivus in an Immunocompetent Patient and a Review of the Literature Regarding Clival Lesions

“…An additional lesion that was considered in the differential diagnosis was a solitary fibrous tumor (SFT), which are rare spindle cell mesenchymal tumors [23]. The confirmation of this diagnosis is based on a positive result for CD34 and a negative result for S100 protein staining in immunohistochemistry [24].…”