Pérez-Núñez A, Rivas J J, Ricoy J R, Miranda P, Arrese I, Lobato R D, Ramos A
Unit of Neurosurgery, Doce de Octubre University Hospital, Avda de Córdoba s/n 28041, Madrid, Spain.
J Neurosurg Sci. 2004 Jun;48(2):59-62.
Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that has been recognized to occur almost all along the organism. Since its description in 1996 at the meninges, a total of 59 cases of meningeal SFT have been reported. Different authors have emphasized the difficulties in the differential diagnosis with other more frequent meningeal neoplasms such as meningioma or hemangiopericytoma, as the clinico-radiological characteristics of this lesion seem to be non specific and the morphological features on pathological study may resemble other spindle cell neoplasms. The diffuse and strong reactivity for CD34 and the negativity for EMA and S-100 are data allowing the diagnosis of SFT. We report the case of a 50-year-old woman suffering from headache, in whom MRI study showed a tentorial lesion initially thought to be a meningioma. In spite of morphological similarities with a fibrous meningioma, inmunohistochemical study finally led to the diagnosis of SFT. As occurred in previous cases, the findings in our patient reflect the similarities in clinico-radiological and pathological characteristics between meningeal SFT and other spindle cell meningeal neoplasms, mainly fibrous meningioma. When a clear diagnosis cannot be done based on typical findings on conventional hematoxylin-eosin study, inmunohistochemical study should be performed in meningeal spindle cell lesions to exclude SFT.
孤立性纤维瘤（SFT）是一种间叶性肿瘤，已被确认几乎可发生于机体的任何部位。自1996年在脑膜被首次描述以来，共报道了59例脑膜SFT。不同作者强调了将其与其他更常见的脑膜肿瘤（如脑膜瘤或血管外皮细胞瘤）进行鉴别诊断的困难，因为该病变的临床放射学特征似乎不具有特异性，且病理研究中的形态学特征可能类似于其他梭形细胞肿瘤。CD34弥漫性强阳性以及EMA和S-100阴性有助于SFT的诊断。我们报告了一例50岁女性头痛患者，其MRI检查显示小脑幕病变，最初被认为是脑膜瘤。尽管其形态与纤维性脑膜瘤相似，但免疫组化研究最终诊断为SFT。正如之前病例一样，我们患者的检查结果反映了脑膜SFT与其他梭形细胞脑膜肿瘤（主要是纤维性脑膜瘤）在临床放射学和病理特征上的相似性。当基于传统苏木精-伊红染色的典型表现无法做出明确诊断时，应对脑膜梭形细胞病变进行免疫组化研究以排除SFT。
