Solitary fibrous tumor of the meninges: Two new cases and review of the literature

BACKGROUND Solitary fibrous tumor (SFT), a mesenchymal neoplasm originally described in the pleura has been more recently reported to arise in a numbe r of other sites, including the meninges. Nowadays immunohistochemistry fac ilitates the otherwise problematic differential diagnosis with regard to ot her benign and malignant spindle cell neoplasms of the central nervous syst em. METHODS Two recently treated cases of meningeal SFT (one craniospinal, one spinal) are presented and discussed in the light of the present knowledge and a rev iew of the literature. RESULTS Total resection was followed by complete recovery and both patients are pre sently asymptomatic and without evidence of disease. The microscopic and im munohistochemical profiles (CD 34, vimentin positive; S-100, EMA negative) were consistent with those of previously reported cases. CONCLUSIONS The majority of SFTs behave in a benign fashion and do not recur unless sub totally resected. Malignant variants may account for up to 37% of SFTs in o ther locations but have never been reported to occur in the meninges. Menin geal SFTs are to be considered a new pathological entity. Wider use of immu nohistochemical screening should enable the determination of their real inc idence; larger series and longer follow-up will provide conclusions about t heir treatment and prognosis. (C) 1999 by Elsevier Science Inc.