A highly vascular intracranial solitary fibrous tumor treated with radiotherapy and toremifene: case report.
OBJECTIVE
A case of an unusual intracranial solitary fibrous tumor with features of high vascularity and resultant difficulty at resection is presented. The use of surgery, radiotherapy, and toremifene has been successful with no recurrence after 18 months.


METHODS
A 33-year-old male patient presented with a 1-year history of loss of vision on the left side and a 3-month history of headache and lethargy. Magnetic resonance imaging showed a lobulated mass (7.6 x 4.5 cm) in the left temporal fossa and left parasellar, sellar, and suprasellar regions, with a "dural tail" more typical of meningioma. Vascular supply was from both the internal carotid arteries and the left middle meningeal artery, precluding embolization.


METHODS
At the time of the craniotomy, a highly vascular tumor was found. Intraoperative hemorrhage limited resection to 20% of the tumor. The histological diagnosis was of a solitary fibrous tumor with an unusually angiomatoid architecture. After the operation, radiotherapy and toremifene were administered. A dramatic reduction in the size of the tumor was seen with no recurrence to date.


CONCLUSIONS
The use of surgery, radiotherapy, and toremifene in treatment of a vascular intracranial solitary fibrous tumor has been successful and warrants further research.
Macfarlane
Rebecca Gillian
RG
Division of Neurosurgery, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, England.
Galloway
Malcolm
M
Plowman
Piers Nicholas
PN
Thomas
David Glyndor Treharne
DG
D000071443:12E7 Antigen; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000628:therapy; D015815:Cell Adhesion Molecules / Q000378:metabolism; D003399:Craniotomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D018218:Neoplasms, Fibrous Tissue / Q000628:therapy*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D016634:Radiosurgery / Q000379:methods*; D017312:Toremifene / Q000627:therapeutic use*; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000628:therapy*
D000071443:12E7 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D018931:Antineoplastic Agents, Hormonal; C061828:CD99 protein, human; D015815:Cell Adhesion Molecules; D019253:Proto-Oncogene Proteins c-bcl-2; D017312:Toremifene