Unusual Presentations of Intracranial Solitary Fibrous Tumor with Malignant Transformation

Background: Intracranial solitary fibrous tumor was rare. However, most intracranial solitary fibrous tumors are benign, cerebral solitary fibrous tumor with malignant transformation was even more unusual. Case present: Herein, we presented a 55 year-old-male who was diagnosed intracranial solitary fibrous tumor five years ago. Partial tumor excision was performed via the pterional craniotomy. Unfortunately, one year later, cerebral solitary fibrous tumor with recurrence on latest operation was diagnosed via follow-up Magnetic Resonance imaging. Reopen the craniotomy site, subtotal removal of tumor and stereotactic radiation surgery were performed. However, four years later, a recurrent tumor was seen via follow-up computed topographic (CT) scans of brain with contrast. A third craniotomy with subtotal removal of tumor was performed. Pathological examination revealed solitary fibrous tumor with malignant transformation. Postoperative CyberKnife stereotactic radiosurgery was performed. One year after resection and CyberKnife stereotactic radiosurgery, a follow-up brain MR images showed tumor regression. Conclusion: Most of intracranial solitary fibrous tumors were benign lesions; however, physician should always keep in mind that malignant transformation may be found in intracranial solitary fibrous tumor.