Malignant intracranial solitary fibrous tumor: A case report and literature review.

Solitary fibrous tumor (SFT), previously termed hemangiopericytoma, is a rare primary intracranial tumor. SFT is classified into grades I, II, and III with different prognoses; grade III tumor has malignant characteristics with a high probability of recurrence and extracranial metastasis. We report the case of a 63-year-old female patient admitted to the Vietnam National Cancer Hospital with headache, dizziness, nausea, ataxia, and loss of balance. Computed tomography showed a markedly enhanced tumor, without calcification, located in the posterior fossa close to the tentorium cerebelli. No changes in the adjacent bone were seen. Magnetic resonance imaging revealed a lobular extra-axial tumor with prominent flow voids, a finding that has been seen frequently in these tumors. The tumor was resected following an initial diagnosis of SFT. Postoperative histology indicated a grade III SFT according to the World Health Organization 2021 classification. SFT is often misdiagnosed as meningioma, as they have some imaging features in common. However, we believe that there are some characteristic magnetic resonance imaging features that help to distinguish between these tumors, as well as playing an essential role in SFT grading and potentially guiding the best therapeutic decision.