Shidoh Satoka, Hida Kazutoshi, Oda Yoshitaka, Sasamori Toru, Shrestha Prabin, Lee Jangbo, Yamaguchi Satoshi
Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.
Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan.
NMC Case Rep J. 2024 Oct 24;11:297-303. doi: 10.2176/jns-nmc.2024-0145. eCollection 2024.
Spinal cord solitary fibrous tumors (SFTs), previously known as hemangiopericytoma (HPC), represent exceedingly rare neoplasms. Strategies for their management, such as appropriate follow-up duration, remain controversial due to their propensity for recurrence despite extended periods of quiescence. We report a 51-year-old male presenting with new-onset back pain and gait disturbances, who had undergone gross total resection (GTR) of an SFT within the thoracic spinal cord 19 years ago. Magnetic resonance imaging of the thoracic spine revealed recurrent tumors at the T7 level within the spinal cord. Subsequent resection achieved GTR. A comprehensive literature review was undertaken to assess the benefits of different resection extents (gross total removal (GTR) vs. subtotal removal (STR)), adjuvant radiation therapy, and the optimal duration of postoperative follow-up. Since 1960, 46 cases, including the present one, have reported recurrent spinal SFT/HPC following GTR and STR. Statistical analyses demonstrated that neither the type of resection nor adjuvant radiation therapy significantly impacted median recurrence-free survival in this cohort. Given their unpredictable behavior, meticulous lifelong follow-up following successful resection appears crucial for managing these tumors effectively.
脊髓孤立性纤维性肿瘤(SFTs),以前称为血管外皮细胞瘤(HPC),是极为罕见的肿瘤。由于其尽管长时间静止但仍有复发倾向,其治疗策略,如适当的随访时间,仍存在争议。我们报告一例51岁男性,出现新发背痛和步态障碍,19年前曾接受胸段脊髓SFT的全切除(GTR)。胸椎磁共振成像显示脊髓内T7水平有复发性肿瘤。随后的切除实现了GTR。进行了全面的文献综述,以评估不同切除范围(全切除(GTR)与次全切除(STR))、辅助放疗以及术后最佳随访时间的益处。自1960年以来,包括本例在内,已有46例报告了GTR和STR后复发性脊柱SFT/HPC。统计分析表明,在该队列中,切除类型和辅助放疗均未对无复发生存期中位数产生显著影响。鉴于其不可预测的行为,成功切除后进行细致的终身随访对于有效管理这些肿瘤似乎至关重要。