Recurrent intracranial solitary fibrous tumor with cerebrospinal fluid dissemination. Case report.
Recurrent intracranial solitary fibrous tumor with cerebrospinal fluid dissemination. Case report.
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DOI：
10.3171/jns.2004.101.6.1045
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发表时间：
2004-12
影响因子：
4.1
通讯作者：
K. Miyashita;Y. Hayashi;H. Fujisawa;M. Hasegawa;J. Yamashita
中科院分区：
文献类型：
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作者：
K. Miyashita;Y. Hayashi;H. Fujisawa;M. Hasegawa;J. Yamashita
孤立性纤维瘤是一种罕见的良性肿瘤。迄今为止，仅报告了37例颅内SFT患者。虽然一些肿瘤复发，有些后来发生恶性转化，这些病变进展到脑脊液（CSF）传播。在本文中，作者报告了一例SFT，其中病变多次复发，并最终由CSF扩散。患者是一名63岁的女性，患有多发性颅内和脊柱肿瘤。15年前，她48岁时因切除镰状幕肿瘤而住院。在随后的15年里，她接受了多次手术和复发性病变的放射治疗。在这15年期间结束时，她的肿瘤在蛛网膜下腔的唯一位置表明肿瘤的CSF扩散。对患者48岁时切除的肿瘤和最近切除的病灶进行免疫组化CD 34、上皮膜抗原、波形蛋白、S100蛋白和网硬蛋白染色，并测定MIB-1标记指数（LI）。大多数结果是相同的，根据染色模式，这两个肿瘤被诊断为SFT，显示了强烈的和弥漫性的阳性反应的CD 34。然而，作者指出，MIB-1 LI从原始肿瘤中的不到1%增加到最近肿瘤中的13%。MIB-1的增殖增加表明恶性转化可能发生在肿瘤复发和CSF扩散期间。
Solitary fibrous tumor (SFT) is a benign and rare neoplasm. To date, only 37 patients with intracranial SFTs have been reported. Although a number of the tumors were recurrent and some later underwent malignant transformation, none of these lesions progressed to cerebrospinal fluid (CSF) dissemination. In this paper the authors report a case of SFT in which the lesion recurred several times and ultimately was disseminated by the CSF. The patient was a 63-year-old woman with multiple intracranial and spinal tumors. Fifteen years before this presentation, at the age of 48 she had been hospitalized for resection of a falcotentorial tumor. During the ensuing 15 years she underwent multiple surgeries and sessions of radiation therapy for recurrent lesions. The exclusive location of her tumors in the subarachnoid space at the end of this 15-year period indicate CSF dissemination of the tumor. The tumor that was resected when the patient was 48 years old and the latest resected lesion were analyzed by performing immunohistological CD34, epithelial membrane antigen, vimentin, S100 protein, and reticulin staining, and determining the MIB-1 labeling index (LI). Most of the results were identical, and both tumors were diagnosed as SFT according to a staining pattern that showed a strong and diffuse positive reaction for CD34. Nevertheless, the authors noted that the MIB-1 LI increased from less than 1% in the original tumor to 13% in the latest tumor. The increased proliferation of MIB-1 indicates that the malignant transformation could have occurred during tumor recurrence with CSF dissemination.