Guo Zhiwang, Wu Tao, Chen Xiaolei, Chang Huimin, Hou Bing
Department of Neurosurgery, Guangdong Provincial Corps Hospital of the Chinese People's Armed Police Forces, Guangzhou, China.
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
J Med Case Rep. 2025 Aug 30;19(1):432. doi: 10.1186/s13256-025-05518-2.
Solitary fibrous tumors are rare central nervous system neoplasms with high rates of local recurrence and distant metastasis. To date, no instances of metastatic dissemination from the spine to the ventricle with malignant progression have been documented.
A 32-year-old male patient of Chinese ethnicity was diagnosed with a grade 2 intraspinal solitary fibrous tumor, demonstrating metastatic spread to the trigone region of the lateral ventricle. Despite cystic degeneration, the solid component of the metastatic lesion exhibited signal intensity similar to that of the primary tumor on imaging. A piecemeal gross total resection was achieved, and postoperative immunohistochemical analysis confirmed that the metastatic lesion was categorized as grade 3, with an increase in the Ki-67 proliferation index from 20% to 30%. Both the primary and metastatic tumors exhibited negative expression of CD34. Although radiotherapy was considered, consensus on its use was not reached, and the patient succumbed to tumor progression 17 months later.
This case underscores the importance of recognizing the potential for malignant transformation and intracranial metastasis in intraspinal solitary fibrous tumors, highlighting the need for vigilant monitoring and possible aggressive treatment strategies.
孤立性纤维瘤是罕见的中枢神经系统肿瘤，局部复发率和远处转移率较高。迄今为止，尚无从脊柱转移至脑室并发生恶性进展的病例报道。
一名32岁的中国男性患者被诊断为2级椎管内孤立性纤维瘤，已转移至侧脑室三角区。尽管发生了囊性变，但转移灶的实性部分在影像学上显示出与原发肿瘤相似的信号强度。实现了分块全切除，术后免疫组化分析证实转移灶分类为3级，Ki-67增殖指数从20%增加到30%。原发肿瘤和转移瘤均显示CD34阴性表达。尽管考虑了放疗，但未就其使用达成共识，患者在17个月后因肿瘤进展死亡。
该病例强调了认识椎管内孤立性纤维瘤发生恶性转化和颅内转移可能性的重要性，突出了需要进行密切监测和可能采取积极治疗策略。
