Combined Intramedullary and Intradural Extramedullary Solitary Fibrous Tumor in Cervical Spine

ABSTRACT

We present a rare case of solitary fibrous tumor (SFT) located in the intramedullary (IM) and intradural extramedullary sites of cervical spine, mimicking thrombosed aneurysm and meningioma. Herein, we present a case of spinal intradural SFT in a 59-year-old woman. She presented to the outpatient clinic with a right-sided motor weakness for over a year. The case was initially misinterpreted as a thrombosed aneurysm of the posterior spinal artery. Cervical spine magnetic resonance imaging revealed a well-circumscribed intradural mass with isosignal intensity on T1 and T2-weighted images with markedly T2 dark signal focus and homogenous intense enhancement at the level of C6. Computed tomography showed a slightly high-density mass without evidence of calcification or cystic component. Surgical removal was performed. However, due to combined IM component with adhesion, incomplete tumor resection was done. Pathologic analysis revealed hypocellular spindle cells with a thick collagenous stroma and immunohistochemical staining confirmed SFT. Spinal intradural SFT is a rare spindle cell tumor. Radiologists should consider SFT as a differential diagnosis if T2-weighted imaging shows an intradural located mass with markedly dark signal intensity focus.