The Spine Journal 15 (2015) 1158–1159
Very rare reason of spinal cord compression: solitary fibrous tumor
also reported [2]. Their imaging characteristics are not specific and mimics neural tumors, especially schwannoma [2–4].
A 43-year-old man presented to the neurosurgery clinic with weakness of lower extremities. There was no history of surgery or trauma. The power in the lower extremities was of Grade 4 or 5. There were no definite sensory deficits. Contrast-enhanced multidetector computed tomography and magnetic resonance imaging were performed. Multidetector computed tomography revealed enhanced solid mass that was compressing spinal cord posteriorly (Fig. 1). The mass also expanded neural foramen. The mass did not contain cystic component and calcification. Magnetic resonance imaging revealed mass localized in the extramedullary and intradural location (Fig. 2), and it was dumbbell shaped. The mass was hypoisointense in the T2-weighted images and isohyperintense in the T1-weighted images comparing muscle intensity (Figs. 2 and 3). The mass was also homogeneous in the contrast-enhanced image (Figs. 2 and 3). These radiologic findings were similar to schwannoma. The patient was operated, and the mass was diagnosed as solitary fibrous tumor with pathologic specimen. The differential diagnosis of an intradural extramedullary lesion of the spinal cord includes schwannoma, nonneoplastic cysts, meningioma, metastases, and inflammatory lesions. Solitary fibrous tumors are usually asymptomatic. Paraplegia and other spinal cord compression symptoms are very rare. There were only a few reports in literature [1]. Mostly, they were benign lesions but a malignant form was
[1] Kurtkaya O, Elmaci I, Sav A, Pamir MN. Spinal solitary fibrous tumor: seventh reported case and review of the literature. Spinal Cord 2001;39:57–60. [2] Nagano A, Ohno T, Nishimoto Y, Oshima K, Shimizu K. Malignant solitary fibrous tumor of the lumbar spinal root mimicking schwannoma: a case report. Spine J 2014;14:e17–20. [3] De Luca G, Griffo S, Cecere C, Cicalese M, Di Tommaso L, Monaco M, et al. Solitary fibrous tumor of the pleura mimicking neurogenic tumor. J Thorac Cardiovasc Surg 2006;132:1241–2. [4] Kakimaru H, Matsusaki M, Sanada H, Iwata A, Uchio Y. Dumbbell-type spinal solitary fibrous tumor with paraplegia. Orthopedics 2009;32:213.
References
Recep Sade, MDa M€urteza C ¸ akır, MDb Hayri Ogul, MDa C ¸ agatay C ¸ alıkoglu, MDb Mecit Kantarci, MD, PhDa a Department of Radiology Medical Faculty Ataturk University Erzurum, Turkey b Department of Neurosurgery Medical Faculty Ataturk University Erzurum, Turkey FDA device/drug status: Not applicable. Author disclosures: RS: Nothing to disclose. MC¸: Nothing to disclose. HO: Nothing to disclose. C¸C¸: Nothing to disclose. MK: Nothing to disclose.
Fig. 1. Axial (Left), coronal (Middle), and sagittal (Right) reformatted thoracic contrast enhanced MDCT images of a 43-year-old man. Dumbbell-shaped contrast-enhanced solid mass (white arrow) compressed spinal cord and expanded neural foramen (black arrow). http://dx.doi.org/10.1016/j.spinee.2015.02.023 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
R. Sade et al. / The Spine Journal 15 (2015) 1158–1159
1159
Fig. 2. Axial T2-weighted (Left), fat saturated T1-weighted (Middle), and contrast-enhanced T1-weighted (Right) thoracic MR images of a 43-year-old man. Dumbbell-shaped solid mass (white arrow) compressed spinal cord. The mass was contrast enhanced and localized in the extramedullary and intradural location.
Fig. 3. Sagittal T2-weighted (Left), fat saturated T1-weighted (Middle), and contrast-enhanced T1-weighted (Right) thoracic MR images of a 43-year-old man. Solid mass compressed spinal cord.
Very rare reason of spinal cord compression: solitary fibrous tumor
also reported [2]. Their imaging characteristics are not specific and mimics neural tumors, especially schwannoma [2–4].
A 43-year-old man presented to the neurosurgery clinic with weakness of lower extremities. There was no history of surgery or trauma. The power in the lower extremities was of Grade 4 or 5. There were no definite sensory deficits. Contrast-enhanced multidetector computed tomography and magnetic resonance imaging were performed. Multidetector computed tomography revealed enhanced solid mass that was compressing spinal cord posteriorly (Fig. 1). The mass also expanded neural foramen. The mass did not contain cystic component and calcification. Magnetic resonance imaging revealed mass localized in the extramedullary and intradural location (Fig. 2), and it was dumbbell shaped. The mass was hypoisointense in the T2-weighted images and isohyperintense in the T1-weighted images comparing muscle intensity (Figs. 2 and 3). The mass was also homogeneous in the contrast-enhanced image (Figs. 2 and 3). These radiologic findings were similar to schwannoma. The patient was operated, and the mass was diagnosed as solitary fibrous tumor with pathologic specimen. The differential diagnosis of an intradural extramedullary lesion of the spinal cord includes schwannoma, nonneoplastic cysts, meningioma, metastases, and inflammatory lesions. Solitary fibrous tumors are usually asymptomatic. Paraplegia and other spinal cord compression symptoms are very rare. There were only a few reports in literature [1]. Mostly, they were benign lesions but a malignant form was
[1] Kurtkaya O, Elmaci I, Sav A, Pamir MN. Spinal solitary fibrous tumor: seventh reported case and review of the literature. Spinal Cord 2001;39:57–60. [2] Nagano A, Ohno T, Nishimoto Y, Oshima K, Shimizu K. Malignant solitary fibrous tumor of the lumbar spinal root mimicking schwannoma: a case report. Spine J 2014;14:e17–20. [3] De Luca G, Griffo S, Cecere C, Cicalese M, Di Tommaso L, Monaco M, et al. Solitary fibrous tumor of the pleura mimicking neurogenic tumor. J Thorac Cardiovasc Surg 2006;132:1241–2. [4] Kakimaru H, Matsusaki M, Sanada H, Iwata A, Uchio Y. Dumbbell-type spinal solitary fibrous tumor with paraplegia. Orthopedics 2009;32:213.
References
Recep Sade, MDa M€urteza C ¸ akır, MDb Hayri Ogul, MDa C ¸ agatay C ¸ alıkoglu, MDb Mecit Kantarci, MD, PhDa a Department of Radiology Medical Faculty Ataturk University Erzurum, Turkey b Department of Neurosurgery Medical Faculty Ataturk University Erzurum, Turkey FDA device/drug status: Not applicable. Author disclosures: RS: Nothing to disclose. MC¸: Nothing to disclose. HO: Nothing to disclose. C¸C¸: Nothing to disclose. MK: Nothing to disclose.
Fig. 1. Axial (Left), coronal (Middle), and sagittal (Right) reformatted thoracic contrast enhanced MDCT images of a 43-year-old man. Dumbbell-shaped contrast-enhanced solid mass (white arrow) compressed spinal cord and expanded neural foramen (black arrow). http://dx.doi.org/10.1016/j.spinee.2015.02.023 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
R. Sade et al. / The Spine Journal 15 (2015) 1158–1159
1159
Fig. 2. Axial T2-weighted (Left), fat saturated T1-weighted (Middle), and contrast-enhanced T1-weighted (Right) thoracic MR images of a 43-year-old man. Dumbbell-shaped solid mass (white arrow) compressed spinal cord. The mass was contrast enhanced and localized in the extramedullary and intradural location.
Fig. 3. Sagittal T2-weighted (Left), fat saturated T1-weighted (Middle), and contrast-enhanced T1-weighted (Right) thoracic MR images of a 43-year-old man. Solid mass compressed spinal cord.
