Solitary fibrous tumour of the spine: imaging features of a commonly misdiagnosed entity

Abstract

Objective

Solitary fibrous tumours (SFTs) occurring in the spine are rare. Herein, we review the clinical and imaging data of spinal SFT.

Methods

We retrospectively analysed eight cases of pathologically confirmed spinal SFT imaging and clinical data, pathological manifestations, surgical methods, and follow-up results.

Results

Five SFTs cases occurred in the cervical spine, two in the thoracic spine, and one in the lumbosacral spine. Five cases showed a dumbbell-shaped or lobulated soft tissue mass that grew across the intervertebral foramen, two cases showed an expansive intraosseous mass formation in the vertebral body and/or posterior element, and one case showed a long-spindle shaped intraspinal canal mass growing along the spinal canal. Seven caused local invasion and destruction of the vertebral body and posterior element. Benign SFTs displayed a good prognosis, whereas malignant SFTs were prone to recurrence and metastasis (3/4).

Conclusion

Spinal SFTs are difficult to characterise with imaging and required pathological and immunohistochemical investigation. Prolonged follow-up is recommended once a diagnosis of spinal SFTs has been established because of the unclear biology.

Key Points

• Spinal solitary fibrous tumours are extremely rare.

• SFTs should be showed the differential of masses developing though the foramen.

• Combing imaging with pathology and immunochemistry assesses the diagnosis and establish nature.