Solitary fibrous tumor of the dura

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Loss of power in lower limbs. Red flag signs. MRI performed out of hours.

Patient Data

Age: 35 years
Gender: Male

1.4cm well defined ovoid intradural, extramedullary mass at the level of T8.   The mass is T1 isointense, T2 mild hyperintense with mild-moderate homogeneous contrast enhancement.

The mass lies in the right side of the spinal canal and compresses and displaces the cord to the left. No abnormality at any other level. Normal bone marrow signal.

Case Discussion

This is a case of an 'Acute Spine' meriting out of hours on call MR imaging.

The differential is for an intradural, extramedullary mass includes:

  1. spinal meningioma
  2. spinal schwannoma
  3. spinal neurofibroma

Spinal surgery was undertaken.   The histological sample was reported as a hemangiopericytoma. In this case, this is likely to be derived from the dura with the now commonly used term of solitary fibrous tumor of the dura most accurately describing its origin. In the new (2016) WHO classification of CNS tumors solitary fibrous tumors and hemangiopericytomas are combined into the one entity, retaining the two terms in recognition of the variable macroscopic presentation

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