Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.
World Neurosurg. 2019 Oct;130:400-404. doi: 10.1016/j.wneu.2019.07.052. Epub 2019 Jul 18.
Intracranial solitary fibrous tumor (SFT) is a rare occurrence and involvement of the fourth ventricle rarely reported. Because of its rarity, some characteristics of intracranial SFT seem to still remain uncertain.
This study describes a very rare case of intracranial SFT in a 55-year-old woman who presented with gait disturbance and numbness in bilateral upper limbs from 3 months before visiting the hospital. Head magnetic resonance imaging scan revealed a homogeneously enhancing mass lesion located primarily in the fourth ventricle extending into the spinal canal and left foramen of Luschka, with a maximum diameter of 60 mm. Notably, this tumor presented spontaneous partial regression during waiting planned surgery without therapy, including chemotherapy and radiotherapy. This patient underwent a midline suboccipital craniotomy and resection of the tumor. Interestingly, there was no attachment to the dura mater of the posterior cranial fossa and the lesion was only attached to the dorsal part of the medulla oblongata.
Although the location of the SFT in the fourth ventricle is rare, SFT should be considered as 1 of the differential diagnosis of fourth ventricle tumors. In addition, this case indicates that SFT in the fourth ventricle may regress on occasion spontaneously without a precisely known cause for this spontaneous partial regression.
颅内孤立性纤维瘤（SFT）是一种罕见的疾病，第四脑室受累的情况更为罕见。由于其罕见性，颅内 SFT 的一些特征似乎仍不确定。
本研究描述了一例非常罕见的颅内 SFT 病例，患者为 55 岁女性，因 3 个月前出现步态不稳和双侧上肢麻木来院就诊。头部磁共振成像扫描显示，一个均匀强化的肿块主要位于第四脑室，延伸至椎管和左侧 Luschka 孔，最大直径为 60mm。值得注意的是，该肿瘤在等待计划手术期间（未接受化疗和放疗等治疗）出现自发部分消退。该患者接受了中线枕下颅后窝切开术和肿瘤切除术。有趣的是，肿瘤与后颅窝硬脑膜无粘连，仅与延髓背侧部分粘连。
尽管第四脑室的 SFT 位置罕见，但 SFT 应被视为第四脑室肿瘤的鉴别诊断之一。此外，该病例表明，第四脑室的 SFT 有时可能会自发消退，但其自发部分消退的确切原因尚不清楚。
