Presentation
Previously known as right frontotemporal intracranial solitary fibrous tumor by histopathology report. The condition started a year before with volume increased in the right temporal region accompanied by sporadic headache of mild intensity.
Patient Data
Sagittal T1-weighted series show a large, well-circumscribed lesion located in the right frontotemporal region, with isointense behavior on T1 sequences and mixed-signal on T2 sequences showing hyperintense and hypointense behavior ("yin-yang" sign).
DWI and ADC sequences show partial restriction.
Gradient Echo series show some artifacts of blooming.
Significant enhancement is shown after the administration of intravenous contrast medium as well as dural tail sign.
Said lesion infiltrates and expands the adjacent bone and extends into the subgaleal soft tissue; exerts a mass effect on the opercular gyrus and obliterates the Sylvian fissure, causing a displacement of midline structures to the left.
Multiple hyperintense nodular images were identified on T2/FLAIR secuences, located in the subcortical and periventricular bilateral white matter. As an additional findings, arachnoid cysts are commented, one is located in the anterior portion of the left middle cranial fossa ando two other at the cerebellopontine angle cisterns as well.
Histopathology report of the incisional biopsy confirming the diagnosis of a solitary fibrous tumor of the dura.
Case Discussion
Intracranial solitary fibrous tumor is a rare neoplasm described for the first time around the mid 90’s by Carneiro et al. These kinds of tumors are typically dural-based neoplasms of mesenchymal origin accounting for ~1% of all primary central nervous system tumors. Is commonly found in the mediastinum and visceral pleura; however, it also occurs in the pleura external sites, such as the head and neck, sinuses, orbits, thyroid, pericardium, peritoneum, liver and mesentery.
This case shows a solid-appearing extra-axial well-circumscribed mass located in the right frontotemporal region that expands to the adjacent bone and subgaleal soft tissue, with heterogeneous signal on T2 weighted series ("yin-yang" appearance).
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