title: Malignant solitary fibrous tumor of the lumbar spinal root mimicking schwannoma: a case report.
abstract: BACKGROUND
  Malignant solitary fibrous tumors (SFTs) arising from the spinal cord are extremely rare and poorly understood mesenchymal neoplasms. To date, only one malignant SFT located in the spinal canal of the sacrum has been described, but none arising from the lumbar nerve root have been reported. Although most SFTs with benign histological features can be treated by complete surgical excision alone, malignant SFTs may require adjuvant therapy. However, systemic chemotherapy and radiotherapy have not been shown effective in patients with malignant SFTs.
  
  
  OBJECTIVE
  To describe a patient with a malignant SFT arising from the lumbar nerve root.
  
  
  METHODS
  A case report and review of literature.
  
  
  METHODS
  We describe the clinical course of the patient and the radiological and pathological findings of the tumor. The effect of systemic chemotherapy was evaluated and the relevant literature was reviewed. This work has no disclosure of funding and was approved by the Institutional Review Board of Gifu University.
  
  
  RESULTS
  The tumor had been resected previously at another hospital, but it recurred and showed multiple metastatic lesions on both lungs within 3 months. Although the patient received systemic chemotherapy, both primary and metastatic lesions were found to be stable disease according to Response Evaluation Criteria in Solid Tumors. The patient died due to cachexia 6 months after her first visit.
  
  
  CONCLUSIONS
  This patient presented with a highly unusual tumor. Even if a tumor is a dumbbell-shaped mass, similar to a neural tumor, SFT should be considered in the differential diagnosis.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagano
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan. Electronic address: takaohno@gifu-u.ac.jp.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Department of Surgical Nursing, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishimoto
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Oshima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology*; D010524:Peripheral Nervous System Neoplasms / Q000188:drug therapy / Q000473:pathology*; D054364:Solitary Fibrous Tumors / Q000188:drug therapy / Q000473:pathology*; D013126:Spinal Nerve Roots / Q000473:pathology*
keywords: Chemotherapy; Lumbar spinal nerve root; Malignant tumor; Solitary fibrous tumor; Spinal cord