gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Solitary fibrous tumor of the posterior fossa

Meeting Abstract

  • Y.M. Ryang - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • M. Oertel - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • K. Nolte - Institut für Neuropathologie, Universitätsklinikum der RWTH Aachen
  • J. Weis - Institut für Neuropathologie, Universitätsklinikum der RWTH Aachen
  • J. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP08-07

DOI: 10.3205/09dgnc335, URN: urn:nbn:de:0183-09dgnc3356

Published: May 20, 2009

© 2009 Ryang et al.
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Outline

Text

Objective: Intracranial solitary fibrous tumors (ISFTs) are rare mesenchymal neoplasms arising from the meninges and were first described in 1996. The majority of tumors occurs in the posterior fossa or spine and may mimic other extra-axial tumors such as fibrous meningioma, hemangiopericytoma or even acoustic schwannoma. Therefore, histological diagnosis is often difficult. We would like to report a case of this rare entity.

Methods: A 43-year-old female patient presented with deterioration of hearing of her right ear accompanied by dizziness since some months prior to admission. On cranial pre-contrast CT scans a heterogeneous, slightly hyperdense lesion was detected which measured 2.2x0.5cm, was located in the right cerebello-pontine angle, infiltrated the petrous bone, and extended into the jugular foramen. MRI showed typical strong but heterogeneous contrast enhancement on the T1-weighted images with thickening of the adjacent meninges (dural tail sign) and hypodense, partially cystic signal intensity on T2-weighted MRI.

Results: Part of the tumor was resected microsurgically. Neurostatus was unchanged postoperatively. The remaining tumor was followed up by MRI and planned for stereotactic radiosurgical treatment in case of tumor progression.

Conclusions: ISFTs have to be considered in the differential diagnosis of meningeal tumors especially when arising from the posterior fossa. On MRI they might be distinguishable from other meningeal neoplasms by their characteristic black-and-white mixed or ying-yang pattern. Because of the rarity of this newly found entity prognosis and natural history of ISFTs are still unknown. Differentiation from anaplastic meningioma, hemangiopericytoma or fibrosarcoma is important due to their tendency towards more aggressive behavior compared to ISFTs. The treatment of choice is total surgical resection if possible. In cases of incomplete removal radiotherapy such as conformal radiation therapy or stereotactic radiosurgery seem to be feasible treatment modalities.