Intramedullary spinal cord solitary fibrous tumor: A rare clinical entity

Introduction: Solitary Fibrous Tumor (SFT) is a rare tumor that initially was thought to arise from visceral tissue. Later reports documented its occurrence in central nervous system tissue, with most located intracranially. Few reports have mentioned intraspinal SFTs, with the majority being extra-medullary. In this report, we describe a rare presentation of intramedullary SFT. Case description: A 52-year-old female was referred for neurosurgical treatment after a medical workup of low back and left leg pain revealed an intramedullary, enhancing mass at T11 with associated syrinx formation. The patient was taken to the operating room, and a multi-level thoracic laminectomy and durotomy was performed to expose the mass. A meticulous resection was initiated but only partially completed because of dense adherence to the spinal cord and nerve roots, with some nervous tissue contained inside the tumor. The patient’s symptoms improved postoperatively. Histopathology documented the presence of a solitary fibrous tumor. Discussion: Only 14 previous cases of intramedullary SFT have been reported. Differentiating SFT from other pathologies is important for correct intraoperative and post-operative management and follow-up. Although most cases of SFT are benign, certain histological characteristics denote the tendency for aggressive conversion, such as increased mitotic figures, nuclear atypia, and an increased proliferation index. In this study, we propose an approach to post-operative follow-up of a patient presenting with intramedullary SFT with benign histological characteristics.