Malignant solitary fibrous tumor of the lumbar spinal root mimicking schwannoma: a case report |
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| Authors: | Akihito Nagano Takatoshi Ohno Yutaka Nishimoto Koji Oshima Katsuji Shimizu |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan;2. Department of Surgical Nursing, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan;1. Department of Orthopaedics and Traumatology, Hacettepe University, Hacettepe Hastaneleri, 06100 Sihhiye, Ankara, Turkey;2. Acibadem Maslak Hastanesi, Büyükdere Cad. No: 40 34457 Maslak, ?stanbul, Turkey;1. Department of Orthopaedics and Sports Medicine, University of South Florida, 13220 USF Laurel Dr, Tampa, FL 33612, USA;2. Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, 13020 N. Telecom Parkway, Tampa, FL 33637, USA;3. Center for Spinal Disorders, Florida Orthopaedic Institute, 13020 N. Telecom Parkway, Tampa, FL 33637, USA;1. ORA Orthopedics, 520 Valley View Drive #100, Moline, IL 61265, USA;2. Orthopaedic and Sports Medicine, Harborview Medical Center, 325 Ninth Ave., Box 359798, Seattle, WA 98104-2499, USA;1. Department of Neurosurgery, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 3021, Kansas City, KS 66160, USA;2. Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada;3. Toronto Western Hospital, 399 Bathurst St, #4W-449, Toronto, ON, Canada;4. Department of Health Services, University of Washington, Box 359455, 4333 Brooklyn Ave NE, Rm 14-315, Seattle, WA 98195-9455, USA;5. Department of Orthopaedic Surgery, Emory University, Emory Orthopaedics & Spine Center, 59 Executive Park South, Atlanta, GA 30329, USA;6. Department of Orthopaedic Surgery, Thomas Jefferson University, Rothman Institute, 925 Chestnut St, 5th Floor, Philadelphia, PA 19107-4216, USA;7. Department of Orthopaedics, University of Utah, University Orthopaedic Center, 590 Wakara Way, Salt Lake City, UT 84108, USA;8. Department of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA 22908-0212, USA;9. Department of Orthopedic Surgery, New England Baptist Hospital, 125 Parker Hill Ave, Boston, MA 02120, USA;10. Boston Spine Group, 299 Washington St, Newton, MA 02458, USA;11. Department of Orthopaedics, University of Washington, Orthopaedic Trauma Surgery Clinic at Harborview, Harborview Medical Center, 1 West Clinic, Box 359798, 325 Ninth Ave, Seattle, WA 98104, USA;12. Spine Education and Research Institute, Center for Spinal Disorders, 9005 Grant St., Suite 200, Thornton, CO 80229, USA;13. Department of Orthopaedic Surgery, Brigham and Women''s Hospital, 75 Francis St., Boston, MA 02115, USA;14. Department of Orthopedic Surgery, Indiana Spine Group, 8040 Clearvista Parkway, Suite 450, Indianapolis, IN 46256, USA;15. The CORE Institute, Center for Orthopedic Research and Education, 3010 W. Agua Fria Fwy #100, Phoenix, AZ 85027, USA;p. Department of Neurosurgery, Johns Hopkins University School of Medicine, Meyer 7-109, 600 North Wolfe St., Baltimore, MD 21287, USA;1. Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, Toronto, Ontario, Canada M5S 3G9;2. Division of Neurosurgery, St Michael''s Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8;1. Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA;2. Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8233, St. Louis, MO 63110, USA |
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| Abstract: | Background contextMalignant solitary fibrous tumors (SFTs) arising from the spinal cord are extremely rare and poorly understood mesenchymal neoplasms. To date, only one malignant SFT located in the spinal canal of the sacrum has been described, but none arising from the lumbar nerve root have been reported. Although most SFTs with benign histological features can be treated by complete surgical excision alone, malignant SFTs may require adjuvant therapy. However, systemic chemotherapy and radiotherapy have not been shown effective in patients with malignant SFTs.PurposeTo describe a patient with a malignant SFT arising from the lumbar nerve root.Study designA case report and review of literature.MethodsWe describe the clinical course of the patient and the radiological and pathological findings of the tumor. The effect of systemic chemotherapy was evaluated and the relevant literature was reviewed. This work has no disclosure of funding and was approved by the Institutional Review Board of Gifu University.ResultsThe tumor had been resected previously at another hospital, but it recurred and showed multiple metastatic lesions on both lungs within 3 months. Although the patient received systemic chemotherapy, both primary and metastatic lesions were found to be stable disease according to Response Evaluation Criteria in Solid Tumors. The patient died due to cachexia 6 months after her first visit.ConclusionThis patient presented with a highly unusual tumor. Even if a tumor is a dumbbell-shaped mass, similar to a neural tumor, SFT should be considered in the differential diagnosis. |
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| Keywords: | Solitary fibrous tumor Spinal cord Chemotherapy Lumbar spinal nerve root Malignant tumor |
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