Dural based solitary fibrous tumour

Case contributed by RMH Neuropathology

Presentation

Not available.

Patient Data

Age: 55
Gender: Male

Post contrast T1 volumetric acquisition through the brain for the purposes of stereotaxis has been obtained. Extra-axial enhancing mass indenting the right posterior temporal lobe is most likely be a meningioma. No unexpected lesion is identified.

Pathology

MICROSCOPIC DESCRIPTION: The section shows a moderately hypercellular tumour. This consists of elongated spindle cells, interspersed with collagen fibres and with a fascicular and storiform architectural arrangement. A single small aggregate of meningothelial cells is noted. The spindled tumour cells show mild nuclear pleomorphism. No mitotic figures or areas of necrosis are identified and there is no evidence of brain invasion. Attachment to dura is noted. Dural margins are clear of tumour. Immunohistochemistry shows strong diffuse staining for CD34 and moderately strong staining for bcl-2 in spindled tumour cells. There is weak staining for epithelial membrane antigen (EMA). No staining for ALK-1 or progesterone receptor (PgR) is seen. The features are of solitary fibrous tumour (WHO Grade II). The topoisomerase labelling index is approximately 2%.

DIAGNOSIS: Brain tumour: Solitary fibrous tumour (WHO Grade II).

Case Discussion

solitary fibrous tumour is a rare neoplasm of mesenchymal origin which can virtually occur in every body site.

Unfortunately this case has only the post contrast T1 (stereotaxis purpose). The case was interpreted on MRI studies as a possible meningioma, which is the most common main differential diagnosis. There are no features permitting this differentiation by imaging. 

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Case information

rID: 34954
Case created: 16th Mar 2015
Last edited: 31st Oct 2015
Inclusion in quiz mode: Included

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