gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Local recurrence of a solitary fibrous tumor (SFT) of the meninges with a loss of CD34 immunopositivity: a diagnostic challenge in a case with seven-year follow-up

Das Lokalrezidiv eines meningealen solitären fibrösen Tumors verlor die Immunoreaktivität für CD34: eine diagnostische Herausforderung in einem Fall mit einer 7-jährigen Nachbeobachtungszeit

Meeting Abstract

  • corresponding author S. A. Kuhn - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität, Jena
  • K. Ebmeier - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität, Jena
  • M. Brodhun - Institut für Pathologie, Klinikum der Friedrich-Schiller-Universität, Jena
  • R. Reichart - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität, Jena
  • D. Katenkamp - Institut für Pathologie, Klinikum der Friedrich-Schiller-Universität, Jena
  • R. Kalff - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität, Jena

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP193

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0461.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Kuhn et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Solitary fibrous tumors (SFT) arise from mesenchymal tissues distributed throughout the human body. They have rarely been described in the central nervous system and its covers. Their diagnosis is complicated by the similarity to other tumor entities like hemangiopericytoma or fibrous meningeoma. Here, we present a case of solitary fibrous tumor of the tentorium cerebelli with supra- and infratentorial extension and a complicated differential diagnosis.

Results

A 33-year-old man noticed personality changes in late 1997 followed by further neurologic deficit. Preoperative magnetic resonance imaging and subtractive cerebral angiography revealed a highly vascularized lesion that was embolized preoperatively. The macroscopic aspect during operation showed strong vascularization despite embolization. Because of sinus infiltration, some tumor tissue was left behind. The patient then disappeared from outpatient care after rehabilitation. After a generalized seizure caused by tumor recurrence in 2000, a second surgical procedure was performed to resect recurrent tumor. Repeated outpatient examinations revealed no further tumor recurrence or metastases (which is common in hemangiopericytoma). Primary tumor tissue exhibited a fibrous tissue pattern with spindle-like cells and hyalinized collagen fiber bundles. Immunohistochemistry was strongly positive for CD34, CD99, bcl-2, and vimentin within tumor cells. CD34 was distributed diffusely throughout the tumor. Immunochemistry was negative for epithelial membrane antigen. A fine reticulin fiber network surrounded groups of tumor cells, but not individual tumor cells as observed in hemangiopericytoma. Local tumor recurrence lost its immunoreactivity for CD34 by keeping all other features. Ki67 proliferation index was low in both the primary tumor and its recurrence. The final diagnosis of a solitary fibrous tumor of the meninges was established, despite CD34 negativity of the recurrent tumor.

Conclusions

We describe the rare case of a meningeal solitary fibrous tumor with local recurrence after three years. The recurrent tumor lost its CD34 reactivity but could be diagnosed as SFT despite of this. While hemangiopericytomas are known as tumors that often recur, seed distant metastasies and end in a bad prognosis, solitary fibrous tumors are relatively benign lesions. Therefore, establishing the tumor diagnosis is important to detemine the patient’s prognosis and evaluate treatment options.