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复发性中枢神经系统孤立性纤维瘤的管理挑战:一例报告

Challenges in the Management of Recurrent CNS Solitary Fibrous Tumors: A Case Report.

作者信息

Bector Gaurav, Trehan Shubam, Jain Prateek, Toofantabrizi Mahyar, Kaur Mandeep

机构信息

Medicine and Surgery, Dayanand Medical College and Hospital, Ludhiana, IND.

Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND.

出版信息

Cureus. 2024 Sep 4;16(9):e68661. doi: 10.7759/cureus.68661. eCollection 2024 Sep.

Abstract

Solitary fibrous tumors (SFTs) of the central nervous system (CNS) are rare mesenchymal neoplasms with diverse histological characteristics ranging from benign to malignant. Their higher chance for metastasis and recurrence poses significant diagnostic and therapeutic challenges. In this study, we present a 53-year-old female with a recurrent SFT of the cervical spine that was diagnosed initially 12 years ago. The patient underwent repeated surgical resections including laminectomy and gamma knife radiosurgery, as well as temozolomide, bevacizumab, and pazopanib therapy. Despite these interventions, she experienced continuous disease progression, with the cancer spreading to vital CNS locations. This study demonstrates the locally invasive nature of CNS SFTs and their complicated treatments involving surgical excision, radiotherapy, and systemic chemotherapy. This study highlights the need for new therapeutic approaches, as the existing methods fall short in meeting all the requirements and continue to lag in targeted therapy research for CNS SFTs. Consequently, it is important to develop individualized treatment strategies for patients affected by such difficult conditions.

摘要

中枢神经系统(CNS)孤立性纤维瘤(SFTs)是罕见的间叶性肿瘤,具有从良性到恶性的多种组织学特征。它们较高的转移和复发几率带来了重大的诊断和治疗挑战。在本研究中,我们报告了一名53岁女性,患有颈椎复发性SFT,最初于12年前确诊。该患者接受了包括椎板切除术和伽玛刀放射外科手术在内的多次手术切除,以及替莫唑胺、贝伐单抗和帕唑帕尼治疗。尽管采取了这些干预措施,她仍经历了疾病的持续进展,癌症扩散至中枢神经系统的重要部位。本研究证明了中枢神经系统SFT的局部侵袭性以及其涉及手术切除、放疗和全身化疗的复杂治疗。本研究强调了新治疗方法的必要性,因为现有方法无法满足所有要求,并且在中枢神经系统SFT的靶向治疗研究方面仍然滞后。因此,为受此类疑难病症影响的患者制定个性化治疗策略非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce72/11452023/17b005e2cc1f/cureus-0016-00000068661-i01.jpg

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