Solitary fibrous tumor of the thoracic spine. Case report and review of the literature

Case report and review of the literature

Sarel J. Vorster M.B., Ch.B.1, Richard A. Prayson M.D.1, and Joung H. Lee M.D.1
View More View Less
  • 1 Departments of Neurosurgery and Neuropathology, The Cleveland Clinic Foundation, Cleveland, Ohio
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓ Solitary fibrous tumor (SFT) is a neoplasm first described as a tumor of mesenchymal origin involving soft tissues. The authors provide a review of the literature with detailed pathological analysis and radiological description of SFTs involving the central nervous system.

The authors report a rare case of a SFT of the thoracic spine in an adult man presenting with myelopathy. Magnetic resonance imaging revealed a well-circumscribed, intradural, extramedullary mass at the T2–3 level. Histological examination demonstrated a proliferation of predominantly spindle-shaped cells with a collagen-matrix background. Immunohistochemical staining was positive for vimentin and CD34 and negative for S-100 and epithelial membrane antigen with an MIB-1 labeling index of 2.6%. Review of the literature revealed 10 cases in which this tumor, frequently found in the pleura, was involved in the central nervous system.

Although rare and their clinical significance as yet unknown, SFTs may be considered in the differential diagnosis of intradural spinal cord lesions. The natural history is also unknown, but these tumors appear to be biologically benign.

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address reprint requests to: Joung H. Lee, M.D., Department of Neurosurgery, S-80, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195.
  • 1.

    Alston SR, , Francel PC, & Jane JA JR: Solitary fibrous tumor of the spinal cord. Am J Surg Pathol 21:477483, 1997 Alston SR, Francel PC, Jane JA JR: Solitary fibrous tumor of the spinal cord. Am J Surg Pathol 21:477–483, 1997

    • Search Google Scholar
    • Export Citation
  • 2.

    Briselli M, , Mark EJ, & Dickersin GR: Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer 47:26782689, 1981 Briselli M, Mark EJ, Dickersin GR: Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer 47:2678–2689, 1981

    • Search Google Scholar
    • Export Citation
  • 3.

    Burger PC, , Scheithauer BW, & Vogel FS (eds): Surgical Pathology of the Nervous System and Its Coverings, ed 3. New York: Churchill Livingstone, 1989, pp 507512 Burger PC, Scheithauer BW, Vogel FS (eds): Surgical Pathology of the Nervous System and Its Coverings, ed 3. New York: Churchill Livingstone, 1989, pp 507–512

    • Search Google Scholar
    • Export Citation
  • 4.

    Carneiro SS, , Scheithauer BW, & Nascimento AG, et al. : Solitary fibrous tumor of the meninges: a lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study. Am J Clin Pathol 106:217224, 1996 Carneiro SS, Scheithauer BW, Nascimento AG, et al: Solitary fibrous tumor of the meninges: a lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study. Am J Clin Pathol 106:217–224, 1996

    • Search Google Scholar
    • Export Citation
  • 5.

    Chaubel A, , Paetau A, & Zoltick P, et al. : CD34 immunoreactivity in nervous system tumors. Acta Neuropathol 88:454458, 1994 Chaubel A, Paetau A, Zoltick P, et al: CD34 immunoreactivity in nervous system tumors. Acta Neuropathol 88:454–458, 1994

    • Search Google Scholar
    • Export Citation
  • 6.

    Civin CI, , Strauss LC, & Brovall C, et al. : Antigenic analysis of hematotoiesis. III. A hematopoietic progenitor cell surface antigen defined by a monoclonal antibody raised against KG-1a cells. J Immunol 133:157165, 1984 Civin CI, Strauss LC, Brovall C, et al: Antigenic analysis of hematotoiesis. III. A hematopoietic progenitor cell surface antigen defined by a monoclonal antibody raised against KG-1a cells. J Immunol 133:157–165, 1984

    • Search Google Scholar
    • Export Citation
  • 7.

    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 13:640658, 1989 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 13:640–658, 1989

    • Search Google Scholar
    • Export Citation
  • 8.

    Flint A, & Weiss SW: CD-34 and keratin expression distinguishes solitary fibrous tumor (fibrous mesothelioma) of pleura from desmoplastic mesothelioma. Hum Pathol 26:428431, 1995 Flint A, Weiss SW: CD-34 and keratin expression distinguishes solitary fibrous tumor (fibrous mesothelioma) of pleura from desmoplastic mesothelioma. Hum Pathol 26:428–431, 1995

    • Search Google Scholar
    • Export Citation
  • 9.

    Goodlad JR, & Fletcher CD: Solitary fibrous tumor arising at unusual sites: analysis of a series. Histopathology 19:515522, 1991 Goodlad JR, Fletcher CD: Solitary fibrous tumor arising at unusual sites: analysis of a series. Histopathology 19:515–522, 1991

    • Search Google Scholar
    • Export Citation
  • 10.

    Hanau CA, & Miettinen M: Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol 26:440449, 1995 Hanau CA, Miettinen M: Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol 26:440–449, 1995

    • Search Google Scholar
    • Export Citation
  • 11.

    Karamitopoulou E, , Perentes E, & Diamantis I, et al. : Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material. Acta Neuropathol 87:4754, 1994 Karamitopoulou E, Perentes E, Diamantis I, et al: Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material. Acta Neuropathol 87:47–54, 1994

    • Search Google Scholar
    • Export Citation
  • 12.

    Klemperer P, & Rabin CB: Primary neoplasms of the pleura. A report of five cases. Arch Pathol 11:385412, 1937 Klemperer P, Rabin CB: Primary neoplasms of the pleura. A report of five cases. Arch Pathol 11:385–412, 1937

    • Search Google Scholar
    • Export Citation
  • 13.

    Malek AM, , Weller SJ, & Price DL Jr, et al. : Solitary fibrous tumor presenting as a symptomatic intraspinal mass: case report. Neurosurgery 40:844847, 1997 Malek AM, Weller SJ, Price DL Jr, et al: Solitary fibrous tumor presenting as a symptomatic intraspinal mass: case report. Neurosurgery 40:844–847, 1997

    • Search Google Scholar
    • Export Citation
  • 14.

    Moran CA, , Suster S, & Koss MN: The spectrum of histologic growth patterns in benign and malignant fibrous tumors of the pleura. Semin Diagn Pathol 9:169180, 1992 Moran CA, Suster S, Koss MN: The spectrum of histologic growth patterns in benign and malignant fibrous tumors of the pleura. Semin Diagn Pathol 9:169–180, 1992

    • Search Google Scholar
    • Export Citation
  • 15.

    Nickoloff BJ: The human progenitor cell antigen (CD34) is localized on endothelial cells, dermal dendritic cells, and perifollicular cells in formalin-fixed normal skin, and on proliferating endothelial cells and stromal spindle-shaped cells in Kaposi's sarcoma. Arch Dermatol 127:523529, 1991 Nickoloff BJ: The human progenitor cell antigen (CD34) is localized on endothelial cells, dermal dendritic cells, and perifollicular cells in formalin-fixed normal skin, and on proliferating endothelial cells and stromal spindle-shaped cells in Kaposi's sarcoma. Arch Dermatol 127:523–529, 1991

    • Search Google Scholar
    • Export Citation
  • 16.

    O'Connell JX, , Logan PM, & Beauchamp CP: Solitary fibrous tumor of the periosteum. Hum Pathol 26:460462, 1995 O'Connell JX, Logan PM, Beauchamp CP: Solitary fibrous tumor of the periosteum. Hum Pathol 26:460–462, 1995

    • Search Google Scholar
    • Export Citation
  • 17.

    Osamura RY: Ultrastructure of localized fibrous mesothelioma of the pleura. Report of a case with histogenetic considerations. Cancer 39:139142, 1977 Osamura RY: Ultrastructure of localized fibrous mesothelioma of the pleura. Report of a case with histogenetic considerations. Cancer 39:139–142, 1977

    • Search Google Scholar
    • Export Citation
  • 18.

    Prayson RA, , McMahon JT, & Barnett GH: Solitary fibrous tumor of the meninges. Case report and review of the literature. J Neurosurg 86:10491052, 1997 Prayson RA, McMahon JT, Barnett GH: Solitary fibrous tumor of the meninges. Case report and review of the literature. J Neurosurg 86:1049–1052, 1997

    • Search Google Scholar
    • Export Citation
  • 19.

    Safneck JR, , Alguacil-Garcia A, & Dort JC, et al. : Solitary fibrous tumor: report of two new locations in the upper respiratory tract. J Laryngol Otol 107:252256, 1993 Safneck JR, Alguacil-Garcia A, Dort JC, et al: Solitary fibrous tumor: report of two new locations in the upper respiratory tract. J Laryngol Otol 107:252–256, 1993

    • Search Google Scholar
    • Export Citation
  • 20.

    Suster S, , Nascimento AG, & Miettinen M, et al. : Solitary fibrous tumor of soft tissue. A clinicopathologic and immunohistochemical study of 12 cases. Am J Surg Pathol 19:12571266, 1995 Suster S, Nascimento AG, Miettinen M, et al: Solitary fibrous tumor of soft tissue. A clinicopathologic and immunohistochemical study of 12 cases. Am J Surg Pathol 19:1257–1266, 1995

    • Search Google Scholar
    • Export Citation
  • 21.

    Tolamaru A, , Toshihiro O, & Tsuneyoshi E, et al. : Prominent meningeal enhancement adjacent to meningioma on Gd-DTPA-enhanced MR images: histopathologic correlation. Radiology 175:431433, 1990 Tolamaru A, Toshihiro O, Tsuneyoshi E, et al: Prominent meningeal enhancement adjacent to meningioma on Gd-DTPA-enhanced MR images: histopathologic correlation. Radiology 175:431–433, 1990

    • Search Google Scholar
    • Export Citation
  • 22.

    Uzoaru I, , Chou P, & Reyes-Mugica M: Malignant solitary fibrous tumor of the pleura. Pediatr Pathol 14:1118, 1994 Uzoaru I, Chou P, Reyes-Mugica M: Malignant solitary fibrous tumor of the pleura. Pediatr Pathol 14:11–18, 1994

    • Search Google Scholar
    • Export Citation
  • 23.

    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 18:814820, 1994 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 18:814–820, 1994

    • Search Google Scholar
    • Export Citation
  • 24.

    Witkin GB, & Rosai J: Solitary fibrous tumor of the upper respiratory tract. A report of six cases. Am J Surg Pathol 15:842848, 1991 Witkin GB, Rosai J: Solitary fibrous tumor of the upper respiratory tract. A report of six cases. Am J Surg Pathol 15:842–848, 1991

    • Search Google Scholar
    • Export Citation
  • 25.

    Young RH, , Clement PB, & McCaughey WT: Solitary fibrous tumors (“fibrous mesotheliomas”) of the peritoneum. A report of three cases and a review of the literature. Arch Pathol Lab Med 114:493495, 1990 Young RH, Clement PB, McCaughey WT: Solitary fibrous tumors (“fibrous mesotheliomas”) of the peritoneum. A report of three cases and a review of the literature. Arch Pathol Lab Med 114:493–495, 1990

    • Search Google Scholar
    • Export Citation
  • 26.

    Zukerberg LR, , Rosenberg AE, & Randolph G, et al. : Solitary fibrous tumor of the nasal cavity and paranasal sinuses. Am J Surg Pathol 15:126130, 1991 Zukerberg LR, Rosenberg AE, Randolph G, et al: Solitary fibrous tumor of the nasal cavity and paranasal sinuses. Am J Surg Pathol 15:126–130, 1991

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 439 104 6
Full Text Views 72 11 1
PDF Downloads 100 8 2
EPUB Downloads 0 0 0