High-cervical solitary fibrous tumour-a case report, and mini-bibliometric analysis

Abstract

We present a case report of a 53-year-old left-handed gentleman who presented with 8 months of right-sided neck pain and radiating arm pain. MRI spine showed suspicion of an intradural, extramedullary lesion initially thought to be a schwannoma. Single-level laminectomy and resection was carried out and noticeable residuum cauterized. Histopathology showed World Health Organization Grade I solitary fibrous tumour (SFT) with Ki-67 of 6%. No major complications post-operatively. Follow-up MRI spine showed gross total resection in the spinal canal with small residual arising from the nerve root. Solitary fibrous tumour are rare mesenchymal tumour especially in the cervical spine. Higher World Health Organization grade and subtotal resection has been associated with higher recurrence rate and metastases. No high-quality evidence available comparing different standards of treatment and follow-up protocol/treatment. Hence, no consensus available with regards to the optimal management, adjuvant therapy, and follow-up protocol. But regular follow-ups recommended especially for higher-grade tumours.

Keywords: diagnosis; follow-up; management; solitary fibrous tumour; spinal cord.

Figure 1

(a) Pre-operative sagittal MRI cervical spine T1-weighted image without contrast. (b) Pre-operative sagittal MRI cervical spine T1-weighted image with contrast.

Figure 2

(a) Pre-operative axial MRI cervical spine T1-weighted image without contrast (across the C1 level). (b) Pre-operative axial MRI cervical spine T1-weighted image with contrast (across the C1 level).