Clinical Report: Accelerated Recurrence of Intracranial Solitary Fibrous Tumor

Overview

This case study presents a 70-year-old male with rapid recurrence of an intracranial solitary fibrous tumor (SFT) after a TERT-wild-type primary tumor.

Background

Intracranial solitary fibrous tumors are rare mesenchymal neoplasms, constituting approximately 0.09% of intracranial tumors. They are typically associated with TERT promoter mutations, which drive malignant progression.

Data Highlights

No numerical or trial data presented in the article.

Key Findings

• The patient had a previously classified CNS WHO grade 2 SFT with a Ki-67 index of approximately 15%.
• Upon recurrence, the tumor exhibited a Ki-67 index of 70% and up to 10 mitotic figures per 10 HPF.
• Diffuse nuclear STAT6 expression was noted, supporting the diagnosis of recurrent SFT.
• Imaging prior to surgery was misinterpreted as recurrent meningioma.
• The original histological slides from the primary tumor were unavailable for review, limiting definitive assessment of progression.

Clinical Implications

Accurate differential diagnosis between SFT and meningioma is essential due to overlapping imaging characteristics.

Conclusion

This case demonstrates the potential for rapid clinical deterioration in intracranial SFTs, particularly those previously classified as TERT-wild-type.

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