Spontaneous Tumor Regression Of Intracranial Solitary Fibrous Tumor Originating From The Medulla Oblongata: A Case Report And Literature Review
Yamaguchi, J., Motomura, K., Ohka, F., Aoki, K., Tanahashi, K., Hirano, M., Nishikawa, T., Shimizu, H., Wakabayashi, T., & Natsume, A. (2019). Spontaneous Tumor Regression of Intracranial Solitary Fibrous Tumor Originating From the Medulla Oblongata: A Case Report and Literature Review. World neurosurgery, 130, 400–404. https://doi.org/10.1016/j.wneu.2019.07.052
View Original Source →Abstract
BACKGROUND: Intracranial solitary fibrous tumor (SFT) is a rare occurrence and involvement of the fourth ventricle rarely reported. Because of its rarity, some characteristics of intracranial SFT seem to still remain uncertain. CASE DESCRIPTION: This study describes a very rare case of intracranial SFT in a 55-year-old woman who presented with gait disturbance and numbness in bilateral upper limbs from 3 months before visiting the hospital. Head magnetic resonance imaging scan revealed a homogeneously enhancing mass lesion located primarily in the fourth ventricle extending into the spinal canal and left foramen of Luschka, with a maximum diameter of 60 mm. Notably, this tumor presented spontaneous partial regression during waiting planned surgery without therapy, including chemotherapy and radiotherapy. This patient underwent a midline suboccipital craniotomy and resection of the tumor. Interestingly, there was no attachment to the dura mater of the posterior cranial fossa and the lesion was only attached to the dorsal part of the medulla oblongata. CONCLUSIONS: Although the location of the SFT in the fourth ventricle is rare, SFT should be considered as 1 of the differential diagnosis of fourth ventricle tumors. In addition, this case indicates that SFT in the fourth ventricle may regress on occasion spontaneously without a precisely known cause for this spontaneous partial regression.
Case Details
Disease Location
Brain
Personal Characteristics
55-year-old woman
Clinical Characteristics
Presented with gait disturbance and numbness in bilateral upper limbs for 3 months before visiting the hospital. Neurological examination revealed numbness in the upper limbs bilaterally, paresis in the 4 limbs, and bilateral dysmetria. Her gait was slow with a wider base than normal. MRI revealed a mass lesion located primarily in the fourth ventricle, extending to the spinal canal and to the left foramen of luschka, with a maximum diameter of 60 mm. The brainstem was compressed. The bilateral posterior inferior cerebellar arteries were the main feeders of this enhancing tumor. After surgery, histologic findings were consistent with an intracranial solitary fibrous tumor (sft).
Remission Characteristics
Regression of the lesion was revealed in the second head MRI scan performed 1 month after the initial preoperative assessment
Treatment & Mechanisms
Proposed Remission Mechanisms
There might be a possibility that the immune response was triggered for some reasons
Clinical Treatment
Dexamethasone, concentrated glycerin, head computed tomography (CT) scan, head MRI, positron emission tomography, and digital subtraction angiography (dsa).
Non-Clinical Treatment
None reported