颅内孤立性纤维瘤:临床、影像学和组织病理学见解及文献复习。
Intracranial solitary fibrous tumors: Clinical, radiological, and histopathological insights along with review of literature.
机构信息
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Department of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
出版信息
Pathol Res Pract. 2024 Aug;260:155456. doi: 10.1016/j.prp.2024.155456. Epub 2024 Jul 8.
BACKGROUND
Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, often challenging to diagnose due to their resemblance to meningiomas and other central nervous system tumors. While advancements in molecular genetics have aided in classification, diagnostic nuances and optimal management strategies remain areas of interest.
MATERIALS AND METHODS
This retrospective study analyzed 11 cases of intracranial SFTs treated at a neurosurgical centre in India between February 2020 and January 2024. Clinical data, radiological findings, histopathological features, and follow-up details were reviewed. Immunohistochemistry, particularly STAT6, facilitated diagnosis confirmation.
RESULTS
The median age of presentation was 32 years, with a male predominance. Headache was the most common presenting symptom, often leading to misdiagnosis as meningiomas on radiological imaging. Histologically, SFTs exhibited spindle to ovoid cells with staghorn vessels and collagenized stroma, posing challenges in differential diagnosis. WHO grading predominantly revealed grade 1 tumors, though recurrence occurred, emphasizing the importance of long-term follow-up. Immunohistochemistry, particularly STAT6, played a pivotal role in distinguishing SFTs from other entities.
CONCLUSION
Intracranial SFTs present diagnostic challenges due to overlapping features with other tumors, warranting a comprehensive approach integrating clinical, radiological, and histopathological findings. Immunohistochemistry, particularly STAT6, emerges as a valuable diagnostic tool. Long-term follow-up is essential for monitoring recurrence and potential malignant transformation. Further research is needed to delineate optimal treatment strategies, including the role of radiotherapy in SFT management.
背景
颅内孤立性纤维瘤(SFT)是一种罕见的间叶性肿瘤,由于其与脑膜瘤和其他中枢神经系统肿瘤相似,因此常常难以诊断。尽管分子遗传学的进步有助于分类,但诊断的细微差别和最佳管理策略仍然是研究的重点。
材料和方法
本回顾性研究分析了 2020 年 2 月至 2024 年 1 月在印度一家神经外科中心治疗的 11 例颅内 SFT 病例。回顾了临床数据、影像学发现、组织病理学特征和随访细节。免疫组织化学,特别是 STAT6,有助于诊断确认。
结果
中位发病年龄为 32 岁,男性居多。头痛是最常见的首发症状,常导致影像学误诊为脑膜瘤。组织学上,SFT 表现为梭形至椭圆形细胞,有鹿角状血管和胶原化基质,这在鉴别诊断中带来了挑战。世界卫生组织分级主要显示为 1 级肿瘤,但有复发发生,强调了长期随访的重要性。免疫组织化学,特别是 STAT6,在区分 SFT 与其他实体瘤方面发挥了关键作用。
结论
颅内 SFT 由于与其他肿瘤具有重叠特征,因此具有诊断挑战性,需要综合临床、影像学和组织病理学发现。免疫组织化学,特别是 STAT6,是一种有价值的诊断工具。需要进行长期随访以监测复发和潜在的恶性转化。需要进一步研究以制定最佳治疗策略,包括放疗在 SFT 管理中的作用。