Low-grade intracranial solitary fibrous tumor with early metastasis to lumbar spine and recurrence twice: case report.

backgroundIntracranial solitary fibrous tumor (ISFT) is a rare and aggressive mesenchymal tumour with a high propensity for recurrence and metastasis. Only a few cases of ISFT metastasis to the vertebral bone have been described. CASE PRESENTATION: We report a case of low-grade ISFT with metastasis to lumbar spine in a 47-year-old female. Her brain magnetic resonance imaging (MRI) showed an extra-axial huge solid mass with slightly lobular-shaped (6.4 cm in the right temporal fossa), which was histopathologically consistent with ISFT, central nervous system (CNS) World Health Organization (WHO) grade 1. She underwent a gross total resection of the tumor and refused radiation therapy after surgery. One year later, she was admitted to the hospital again, complaining of waist pain with numbness in the right lower limb. A 25 × 23 × 23 mm bone destruction area at the right posterior part of the L5 vertebral body was found on the lumbar MRI and proved to be metastatic ISFT, CNS WHO grade 3 by pathological examination. She underwent surgical resection of the L5 vertebral tumor and refused postoperative radiotherapy again. In the next two years, she experienced twice local recurrence of intracranial tumor and was treated with gamma knife therapy.

conclusionThis is the first report of low-grade ISFT with metastasis to the lumbar spine, accompanied by the shortest time interval reported thus far. The tumor recurred twice within the next two years. This case prompts that low-grade tumors have the potential for high-risk metastasis and repeatedly local recurrence, may be associated with no postoperative radiotherapy.