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酷似脑膜瘤的颅内孤立性纤维瘤

Intracranial Solitary Fibrous Tumor Mimicking Meningioma.

作者信息

Tao Xiaowei, Yan Xuelei, Zhang Yifei, Qin Shiqiang

机构信息

School of Clinical Medicine, Weifang Medical University, Weifang, Shandong.

Department of Neurosurgery, Weifang People's Hospital Affiliated to Weifang Medical University, Weifang, Shandong Province, People's Republic of China.

出版信息

J Craniofac Surg. 2023 Oct 1;34(7):e688-e690. doi: 10.1097/SCS.0000000000009598. Epub 2023 Aug 15.

Abstract

Solitary fibrous tumor (SFT) is a clinically rare tumor derived from mesenchymal spindle cells. Central nervous system SFT represents only 0.09% of tumors occurring on the meninges, while intracranial solitary fibrous tumors (ISFT) are even more rare. Due to the similar genetic characteristics it shares with hemangiopericytoma, in 2016, the World Health Organization (WHO) classified it as a single disease called solitary fibrous tumor (SFT)/hemangiopericytoma. We reported a case of a 60-year-old female with an intracranial solitary fibrous tumor (ISFT). The patient's magnetic resonance imaging showed a mass adhering extensively to the dura mater, with adjacent thickening of the meninges and evidence of a meningeal tail sign. These radiologic findings suggested a meningioma. The tumor was surgically removed and sent for pathologic examination, which confirmed that the tumor was consistent with a solitary fibrous tumor(WHO III). Due to its rarity and similarities with meningioma, ISFT is often misdiagnosed as other types of brain tumors. ISFT is poorly understood and poses a diagnostic challenge. Our case report presents several features suggestive of meningioma, but histopathological examination after surgery confirmed the diagnosis of SFT. Knowledge of these tumors is crucial for neurosurgeons to include them in preoperative differential diagnosis.

摘要

孤立性纤维瘤(SFT)是一种临床上罕见的起源于间充质梭形细胞的肿瘤。中枢神经系统SFT仅占脑膜肿瘤的0.09%,而颅内孤立性纤维瘤(ISFT)更为罕见。由于它与血管外皮细胞瘤具有相似的遗传特征,2016年,世界卫生组织(WHO)将其归类为一种单一疾病,称为孤立性纤维瘤(SFT)/血管外皮细胞瘤。我们报告了一例60岁女性颅内孤立性纤维瘤(ISFT)病例。患者的磁共振成像显示一个肿块广泛附着于硬脑膜,相邻脑膜增厚并有脑膜尾征。这些影像学表现提示为脑膜瘤。肿瘤经手术切除并送病理检查,结果证实该肿瘤符合孤立性纤维瘤(WHO III级)。由于其罕见性以及与脑膜瘤的相似性,ISFT常被误诊为其他类型的脑肿瘤。人们对ISFT了解甚少,它构成了诊断挑战。我们的病例报告展示了一些提示脑膜瘤的特征,但手术后的组织病理学检查证实为SFT诊断。对于神经外科医生来说,了解这些肿瘤对于将其纳入术前鉴别诊断至关重要。

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