Solitary fibrous tumor in the cervical spine with destructive vertebral involvement: a case report and review of the literature.
BACKGROUND
Recently, solitary fibrous tumors occurring in spine-related lesions have been reported. However, the destruction of vertebral bodies by this type of tumor has not been reported.


METHODS
A 71-year-old female presented with pain from a mass on the right side of her neck. Plain radiographs of the cervical spine showed collapse of the C5 vertebral body and dislocation of the C4 vertebral body. The MRI image showed a large mass surrounding C4 and C5, which had low signal intensity in the T1W image and high signal intensity in the T2W image. At first, resection of the tumor and spinal fusion was performed by anterior approach.


RESULTS
Histology revealed a solitary fibrous tumor with proliferating spindle cells. Immunohistochemistry showed positive stains for vimentin and CD34. One year postoperatively, a local recurrence manifested extensive destruction of the C4 and C5 vertebral bodies. Then, palliative surgery with posterior cervical instrumentation and radiation therapy were performed. Because the destruction proceeded and the rods were broken 2 years after, she underwent additional occipito-cervical instrumentation.


CONCLUSIONS
This is the first report of a solitary fibrous tumor that involves the destruction of the spinal structure. An extensive destruction of the vertebral body by the solitary fibrous tumor needs to be aware in treating this tumor with spinal involvement.
Hashimoto
Koji
K
Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu City, Gifu, Japan. beam-kjh@par.odn.ne.jp
Miyamoto
Kei
K
Hosoe
Hideo
H
Kawai
Gou
G
Kikuike
Kenta
K
Shimokawa
Kuniyasu
K
Suzuki
Naoki
N
Matsuo
Masayuki
M
Kodama
Hirotaka
H
Shimizu
Katsuji
K
D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D006801:Humans; D011859:Radiography; D012086:Reoperation; D054364:Solitary Fibrous Tumors / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome