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Solitary Fibrous Tumors of the Central Nervous System: Clinical Features and Imaging Findings in 22 Patients

Wang, Xiao-Qiang*; Zhou, Qing MD; Li, Shi-Ting PhD*; Liao, Chen-Long MD*; Zhang, Hua MD; Zhang, Bi-Yun PhD§

Journal of Computer Assisted Tomography: September/October 2013 - Volume 37 - Issue 5 - p 658–665
doi: 10.1097/RCT.0b013e3182a05687
Neuroradiology

Introduction: Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm originating in the central nervous system (CNS), with imaging features currently not well known. The purposes were to describe and characterize clinical features and imaging findings of CNS SFT.

Methods: We retrospectively reviewed computed tomographic (CT; n = 10) and magnetic resonance (MR) images (n = 18) of 22 patients with SFT (13 males and 9 females; mean, 47.6 years) with associated clinical records.

Results: Each lesion was found as a solitary, well-defined mass, ranging in size from 12 to 70 mm (mean, 38 mm). The tumor shape was roundlike in 16 cases (72.7%) and irregular in 6 cases (27.2%). The cerebellopontine angle zone was the most affected area (n = 6). On precontrast CT scans, 10 cases showed predominantly hyperattenuation (n = 9) and isoattenuation (n = 1). No lesion contained calcification, and 2 cases showed bone invasions. All 18 tumors examined by MR imaging showed homogeneous hypointensive (n = 5) or isointensive (n = 7) signal intensity and heterogeneous mixed isointense and hypointense signal intensity (n = 6) on T1-weighted images, whereas most tumors were predominantly isointense (n = 13) and hypointense (n = 4) to the cortex on T2-weighted images; on postcontrast CT and MR images, enhancement was marked homogeneous (n = 10) or heterogeneous (n = 12). Fourteen tumors had thickening of the meninges adjacent to the tumor.

Conclusions: Although SFT is a rare neoplasm in the CNS, it should be considered in the differential diagnosis. The most affected area is the cerebellopontine angle zone. Solitary fibrous tumor tends to have some imaging features, such as high attenuation on CT, isointense to hypointense signal intensity on MR images, and marked enhancement.

From the *Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai; †Department of Medical Oncology, Jiangsu Provincial Cancer Hospital, Nanjing; ‡Department of Ultrasonography, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai; and §Department of Radiotherapy, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China.

Received for publication March 21, 2013; accepted June 12, 2013.

Reprints: Bi-Yun Zhang, PhD, Department of Radiotherapy, Jiangsu Province Hospital of Traditional Chinese Medicine, 155, Hanzhong Rd, Nanjing, China 210029 (e-mail: aurora@fudan.edu.cn); Hua Zhang, MD, Department of Ultrasonography, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665, Kongjiang Rd, Shanghai, China 200092 (e-mail: zhanghua617@126.com).

Xiao-Qiang Wang and Qing Zhou contributed equally to this work.

This study is supported by grants from China Postdoctoral Science Foundation (no. 20100480568).

The authors declare no conflict of interest concerning the materials or methods used in this study or the findings specified in this article.

© 2013 by Lippincott Williams & Wilkins