Presentation
Not available.
Patient Data
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.
MICROSCOPIC DESCRIPTION: The section shows a moderately hypercellular tumor. This consists of elongated spindle cells, interspersed with collagen fibers and with a fascicular and storiform architectural arrangement. A single small aggregate of meningothelial cells is noted. The spindled tumor 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 tumor. Immunohistochemistry shows strong diffuse staining for CD34 and moderately strong staining for bcl-2 in spindled tumor 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 tumor (WHO Grade II). The topoisomerase labeling index is approximately 2%.
DIAGNOSIS: Brain tumor: Solitary fibrous tumor (WHO Grade II).
Case Discussion
A solitary fibrous tumor 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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