Solitary Fibrous Tumor of the Meninges in the Posterior Cranial Fossa. Magnetic Resonance Imaging and Histological Correlation. Case Report.

Abstract

A 58-year-old female presented with a rare case of intracranial solitary fibrous tumor (SFT) manifesting as progressive ataxic gait and hearing loss on the left persisting for 6 months with recent symptoms of increased intracranial pressure. Computed tomography demonstrated a large isodense irregular-shaped mass in the left posterior cranial fossa. T2-weighted magnetic resonance imaging showed two components appearing as very low intensity and high intensity. Extreme-lateral suboccipital craniotomy was performed. Gross total resection was achieved except for some dural attachment in the jugular foramen. All symptoms and signs subsided after surgery. Histological, immunohistochemical, and electron microscopic examinations led to a diagnosis of SFT. The strongly hypointense areas on the T2-weighted images were hypocellular region characterized by disorganized spindle cells and thick bands of collagen. The hyperintense areas on the T2-weighted images were hypercellular region mimicking hemangiopericytoma. Strong immunoreactivity for CD34 was also helpful in the diagnosis. Electron microscopy revealed absence of pinocytic vesicles and dense laminae which are characteristic of hemangiopericytoma. The magnetic resonance imaging appearance of SFT seems to be pathognomonic.

Intracranial Solitary Fibrous Tumors: Imaging Findings in 6 Consecutive Patients

“…This feature on T2-weighted images has the appearance of a "black-and-white" mixed pattern or ying-yang pattern. Nawashiro et al 15 suggested that the imaging findings are due to collagenous hypocellular regions and hypercellular regions with "staghorn" vascular pattern capillaries, which, respectively, correspond with the area of low signal intensity and the area of high signal intensity on T2-weighted images. Most solid portions of the lesions showed heterogeneous strong enhancement.…”

“…[12][13][14] Moreover, there is only limited description of imaging features of SFT affecting the intracranial region. 15,16 The purpose of this study was to describe the MR imaging, CT imaging, and angiographic features of pathologically proven ISFT and to identify imaging characteristics.…”

Solitary Fibrous Tumor of the Thoracic Spinal Cord-Case Report-

“…The majority of intracranial SFTs had a dural origin, whereas one third of spinal SFTs had a dural attachment. 2,8,10,13) Since the present tumor was continuous with the spinal nerve root and not attached to the dura mater, the origin seemed to be the pial or vascular tissue of the nerve root.…”

“…Recently, SFT has been found in the central nervous system (CNS). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] We report a case of intradural extramedullary SFT of the thoracic spine.…”

Recurrent Solitary Fibrous Tumor of the Falx Cerebri With Intraventricular Extension-Case Report-

“…5,14) MR imaging shows SFT as isointense on T 1 -weighted images, hyperintense on T 2 -weighted images, and homogeneous enhancement after intravenous administration of gadolinium. 11,17) The clinical behavior of SFT is generally considered to be benign if the tumor is totally removed. 12) Recently, stereotactic radiosurgery as adjuvant treatment for residual SFT has been advocated, but experience with more cases is needed.…”