Qian Huan, Zheng Pan, Guo Sanjun, He Yulin, Yang Yue, Sun Huajun
Department of Pathology, The First People's Hospital of Guangyuan, Guangyuan, 628017, Sichuan, China.
Department of Neurosurgery, The First People's Hospital of Guangyuan, Guangyuan, 628017, Sichuan, China.
Discov Oncol. 2025 Apr 26;16(1):622. doi: 10.1007/s12672-025-02370-0.
Intracranial solitary fibrous tumor (ISFT) is a rare and aggressive mesenchymal tumour with a high propensity for recurrence and metastasis. Only a few cases of ISFT metastasis to the vertebral bone have been described.
We report a case of low-grade ISFT with metastasis to lumbar spine in a 47-year-old female. Her brain magnetic resonance imaging (MRI) showed an extra-axial huge solid mass with slightly lobular-shaped (6.4 cm in the right temporal fossa), which was histopathologically consistent with ISFT, central nervous system (CNS) World Health Organization (WHO) grade 1. She underwent a gross total resection of the tumor and refused radiation therapy after surgery. One year later, she was admitted to the hospital again, complaining of waist pain with numbness in the right lower limb. A 25 × 23 × 23 mm bone destruction area at the right posterior part of the L5 vertebral body was found on the lumbar MRI and proved to be metastatic ISFT, CNS WHO grade 3 by pathological examination. She underwent surgical resection of the L5 vertebral tumor and refused postoperative radiotherapy again. In the next two years, she experienced twice local recurrence of intracranial tumor and was treated with gamma knife therapy.
This is the first report of low-grade ISFT with metastasis to the lumbar spine, accompanied by the shortest time interval reported thus far. The tumor recurred twice within the next two years. This case prompts that low-grade tumors have the potential for high-risk metastasis and repeatedly local recurrence, may be associated with no postoperative radiotherapy.
颅内孤立性纤维瘤（ISFT）是一种罕见的侵袭性间叶性肿瘤，具有较高的复发和转移倾向。仅有少数ISFT转移至椎骨的病例被报道。
我们报告一例47岁女性低度ISFT转移至腰椎的病例。她的脑部磁共振成像（MRI）显示右侧颞窝有一个6.4厘米的轴外巨大实性肿块，略呈分叶状，组织病理学检查与ISFT相符，为中枢神经系统（CNS）世界卫生组织（WHO）1级。她接受了肿瘤全切手术，术后拒绝放疗。一年后，她再次入院，主诉腰痛伴右下肢麻木。腰椎MRI显示L5椎体右后部有一个25×23×23毫米的骨质破坏区，病理检查证实为转移性ISFT，CNS WHO 3级。她接受了L5椎体肿瘤的手术切除，术后再次拒绝放疗。在接下来的两年里，她颅内肿瘤局部复发两次，接受了伽马刀治疗。
这是首例低度ISFT转移至腰椎的报告，且转移间隔时间为迄今报道最短。该肿瘤在接下来的两年内复发两次。此病例提示低度肿瘤有高风险转移及反复局部复发的可能，可能与术后未行放疗有关。
