Intracranial Solitary Fibrous Tumor with Pseudopapillary Architecture: An Uncommon Tumor with Unusual Histopathology
Keywords:
solitary fibrous tumor, central nervous system, intracranial, pseudopapillaryAbstract
Solitary fibrous tumor (SFT) is an uncommon soft tissue neoplasm first described in the pleura in 1931 and later recognized in other anatomical locations. Involvement of the central nervous system is rare; there are approximately 250 cases of central nervous system SFTs in the English literature. To the best of our knowledge, this is the first report of an intracranial SFT showing pseudopapillary architecture. The patient was a 73-year-old male who presented with recent onset altered mental status. Imaging studies showed a large left posterior parieto-occipital region intradural extra-axial mass with significant mass effect in the adjacent brain. Neuropathologic examination demonstrated a spindled mesenchymal neoplasm with variable cellularity and prominent collagen deposition. In areas, the tumor was discohesive, imparting a prominent pseudopapillary architecture. Entrapped brain parenchyma was present, indicating brain infiltration. The tumor cells were positive for CD34, CD99, vimentin, BCL-2, and STAT6; EMA was negative. Both the Ki-67 and mitotic indices were low, and anaplastic nuclear features were absent. To the best of our knowledge, this is the first example of an intracranial SFT with pseudopapillary architecture. Occasional extracranial SFTs showing papillary features have been reported. The significance of this architectural pattern is unclear and may be elucidated by future studies.
[N A J Med Sci. 2016;9(4):181-186. DOI: 10.7156/najms.2016.0904181]
Key Words: solitary fibrous tumor, central nervous system, intracranial, pseudopapillary
References
2. Fletcher CD, Hogendoorn P, Mertens F, Bridge J. WHO Classification of Tumours of Soft Tissue and Bone. 4th ed. Lyon, France: IARC Press; 2013.
3. Carneiro SS, Scheithauer BW, Nascimento AG, Hirose T, Davis DH. Solitary fibrous tumor of the meninges: a lesion distinct from fibrous meningioma: a clinicopathologic and immunohistochemical study. Am J Clin Pathol. 1996;106:217-224.
4. Prayson RA, McMahon JT, Barnett GH. Solitary fibrous tumor of the meninges: Case report and review of the literature. J Neurosurg. 1997;86:1049-1052.
5. Martin AJ, Fisher C, Igbaseimokumo U, Jarosz JM, Dean AF. Solitary fibrous tumours of the meninges: case series and literature review; This work was presented in abstract form to the Centenary Meeting of the British Neuropathological Society, London, 10–12 January 2001. J Neuro Oncol. 2001;54:57-69.
6. Tihan T, Viglione M, Rosenblum MK, Olivi A, Burger PC. Solitary fibrous tumors in the central nervous system: a clinicopathologic review of 18 cases and comparison to meningeal hemangiopericytomas. Arch Pathol Lab Med. 2003;127:432-439.
7. Caroli E, Salvati M, Orlando ER, Lenzi J, Santoro A, Giangaspero F. Solitary fibrous tumors of the meninges. Neurosurg Rev. 2004;27:246-251.
8. Metellus P, Bouvier C, Guyotat J, et al. Solitary fibrous tumors of the central nervous system: clinicopathological and therapeutic considerations of 18 cases. Neurosurg. 2007;60:715-722.
9. Bisceglia M, Galliani C, Giannatempo G, et al. Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996–July 2011). Adv Anat Pathol. 2011;18:356-392.
10. Metellus P, Bouvier C, Guyotat J, et al. Solitary fibrous tumors of the central nervous system: clinicopathological and therapeutic considerations of 18 cases. Neurosurg. 2007;60:715-722.
11. Tomek M, Bravi I, Mendoza N, et al. Spinal extradural solitary fibrous tumor with retiform and papillary features. Ann Diagn Pathol. 2013;17:281-287.
12. Wen G, Li M, Xu L, et al. Solitary fibrous tumor of the central nervous system: report of 2 cases and review of literature. Int J Clin Exp Pathol. 2014;7:3444.
13. Yoshida A, Tsuta K, Ohno M, et al. STAT6 immunohistochemistry is helpful in the diagnosis of solitary fibrous tumors. Am J Surg Pathol. 2014;38:552-559.
14. Doyle LA, Vivero M, Fletcher CD, Mertens F, Hornick JL. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics. Mod Pathol. 2014;27:390-395.
