Primary Solitary Fibrous Extradural Tumor of Thoracic Spine: A Case Report

Document Type : Case Reports

Authors

1 Department of Neurosurgery, Dr. D. Y Patil Medical College

2 Neurosurgery,Dr. D.Y. Patil hospital Pimpri Pune Maharashtra India

3 Department of neurosurgery, Dr D Y Patil Medical College

4 department of neurosurgery, d Y patil Medical college, pune-18

5 Director and Consultant Oncopathologist Megavision Labs Pvt Ltd.

6 Department of neurosurgery DPU Dr.D.Y. Patil hospital Pimpri Pune 411018

Abstract

Background Data: Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare central nervous system (CNS) tumor. Its incidence in the spine is even rarer. It is diagnosed histopathologically as preoperative imaging reveals no pathognomonic features. It is most common in the thoracic spine and may have a poor prognosis despite surgery and adjuvant therapy. We present a case of thoracic extradural spinal primary SFT to be added to the list of the few reported cases.
Purpose: To report a rare tumor of extradural SFT in the thoracic spine.
Study Design: A case report.
Patient and Methods: We report one of a middle-aged female who presented with sensory and motor weakness for 2 months. With relevant work-up and an MRI imaging, an extradural lesion was noted in the spine. The patient underwent an en bloc resection of the lesion with a smooth postoperative course and the specimen was analyzed for histopathology.
Result: The histopathological analysis of the specimen showed features suggestive of a SFT; immunohistochemistry (IHC) was correlated with the histopathological diagnosis. At the 3-month follow-up, the patient had improvement in the power of the lower limbs and spasticity from grade 7/11 to grade 10/11 according to thoracic myelopathy JOA score.
Conclusion: SFTs are rare tumors whose clinical course is unpredictable. They commonly occur in intradural extramedullary and rarely extradural sites. The goal of treatment is complete excision. (2020ESJ212)
Abstract

Background Data: Solitary fibrous tumor/ Solitary fibrous tumor/ Haemangiopericytoma (SFT/HPC) is a rare tumour of CNS. Its incidence in spine is even rarer. It is a mainly a histopathalogical diagnosis as preoperative imaging has no pathognomic features. Most common in the dorsal spine and has poor prognosis despite surgery and adjuvant therapy despite its pathological behavior. It has been cited most commonly only as case reports.

Purpose: To add to literature of a rare tumor of the CNS especially in the spine.

Study Design: Case Report

Patient and methods: We are adding one such case of a dorsal extradural spinal primary SFT to the list of few cases that have already been reported. We present One such case in a middle age female who presented with sensory motor weakness for a period of 2 months. With relevant work up and an MRI imaging in which an extradural lesion was noted in the spine. Patient underwent an enbloc resection of the lesion and the specimen was analyzed for histopathology.

Result:The histopathological analysis of the specimen showed features suggestive of solitary fibrous tumor with IHC studies correlating with the histopathological diagnosis. On 3-month post operative follow-up the patient she had improvement in the power of the lower limbs and spasticity.

Conclusion: SFTs are rare tumours whose clinical course is unpredictable. They commonly occur in intradural extramedullary sites. Spinal involvement is a reported rare occurrence. The lack of large case series is attributed to its poor understanding. The goal of treatment is complete excision.

Key: SFT, Spine, Rare, Extradural

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