Difficulties in differential diagnosis of intracranial solitary fibrous tumor: a clinical case
https://doi.org/10.22328/2079-5343-2025-16-4-102-113
Abstract
According to the 5th edition of the World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS), published in 2021, solitary fibrous tumor (SFT) has been established as a distinct nosological entity within the category of rare mesenchymal neoplasms, exhibiting a propensity for early recurrence and systemic dissemination.The limited prevalence of SFTs accounts for the scarcity of publications describing their specific neuroimaging patterns, while the clinicopathological features of this tumor have been well-characterized. The lack of robust diagnostic criteria poses significant challenges in differentiating SFTs from other intracranial neoplasms, which require fundamentally distinct therapeutic approaches. This report describes the clinical case of a 40-year-old male patient presenting with headache, systemic dizziness, recurrent syncopal episodes, and generalized tonic-clonic seizures over a two-month period. Brain MRI revealed an extra-axial mass in the left parasellar region, attached with its base to the dura mater, accompanied by perifocal edema, mass effect of the left temporal lobe, prominent vascularity, intense homogeneous contrast enhancement, and elevated perfusion values. The preoperative differential diagnosis included meningioma, schwannoma, dural metastatic lesion, chondrosarcoma, and MALT lymphoma. The «YinYang» sign emerged as the most significant diagnostic criterion, characterized by heterogeneous tumor signal intensity on T2- and T2-FLAIR sequences. The patient underwent microsurgical resection of the tumor. Histopathological examination confirmed the diagnosis of SFT. Thus, the use of a comprehensive multiparametric MRI protocol enables a high-probability preoperative suspicion of SFT, which is critical for surgical planning.
About the Authors
M. M. Akulov
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Mikhai M. Akulov — Radiologist
625039, Tyumen, Melnikaite St., 75
R. S. Talybov
Regional Clinical Hospital No. 2 ; Tyumen State Medical University
Russian Federation
Russian Federation
Rustam S. Talybov —Cand. of Sci. (Med.), Radiologist, assistant of the Department of Oncology with a course of radiation diagnostics and radiation therapy
Tyumen, Odesskaya St., 54, 625023
T. M. Kleschevnikova
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Tatyana M. Kleschevnikova — Head physician
625039, Tyumen, Melnikaite St., 75
V. I. Pavlova
Regional Clinical Hospital No. 2 ; Multidisciplinary Clinical Medical Center «Medical City»
Russian Federation
Russian Federation
Valeria I. Pavlova — Cand. of Sci. (Med.), Head of the Department of Oncology with a course of radiation diagnostics and radiation therapy
Tyumen, Odesskaya St., 54, 625023
T. N. Trofimova
Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
Tatyana N. Trofimova — Dr. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Professor of the radiology department and radiation medicine
197022, St. Petersburg, L’va Tolstogo St., 6–8
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For citations:
Akulov M.M., Talybov R.S., Kleschevnikova T.M., Pavlova V.I., Trofimova T.N. Difficulties in differential diagnosis of intracranial solitary fibrous tumor: a clinical case. Diagnostic radiology and radiotherapy. 2025;16(4):102-113. (In Russ.) https://doi.org/10.22328/2079-5343-2025-16-4-102-113
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