Bruder Markus, Tews Dominique, Mittelbronn Michel, Capper David, Seifert Volker, Marquardt Gerhard
Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Department of Neuropathology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
World Neurosurg. 2015 Jul;84(1):189.e7-189.e12. doi: 10.1016/j.wneu.2015.02.036. Epub 2015 Mar 6.
Solitary fibrous tumors (SFTs) are benign tumors of the soft tissue occurring anywhere in the human body but arise predominantly in the visceral pleura. SFTs of the central nervous system are rare, especially when they occur within the spinal cord.
We present a case of an 83-year-old female patient presenting with acute spastic paralysis of the lower extremities after a history of progressive weakness and incontinence. Magnetic resonance imaging (MRI) findings were typical for meningioma, but an intradural, mainly intramedullary tumor was found at the first operation. A second operation was performed under neurophysiological monitoring, and complete removal of the tumor was achieved. Neurological conditions improved after the procedure, but the patient remained paraparetic. Histological and immunohistochemical findings revealed an SFT.
There is evidence that SFTs and hemangiopericytomas (HPCs) are not different entities but should be considered as different graduations of a common spectrum. The extent of resection is a prognostic factor for recurrence-free survival in SFT; therefore we recommend surgery with complete resection whenever possible depending on the results of mandatory intraoperative neurophysiological monitoring in these cases.
孤立性纤维性肿瘤（SFTs）是一种软组织良性肿瘤，可发生于人体的任何部位，但主要起源于脏层胸膜。中枢神经系统的SFTs较为罕见，尤其是发生在脊髓内时。
我们报告一例83岁女性患者，该患者在出现进行性肌无力和尿失禁病史后，出现下肢急性痉挛性瘫痪。磁共振成像（MRI）表现典型为脑膜瘤，但在首次手术时发现为硬膜内肿瘤，主要位于髓内。在神经生理监测下进行了第二次手术，肿瘤被完全切除。术后神经状况有所改善，但患者仍为双下肢轻瘫。组织学和免疫组化结果显示为SFT。
有证据表明，SFTs和血管外皮细胞瘤（HPCs）并非不同的实体，而应被视为同一谱系的不同分级。切除范围是SFT无复发生存的预后因素；因此，根据这些病例术中强制性神经生理监测的结果，我们建议尽可能进行完整切除手术。
