Báo cáo một trường hợp u xơ đơn độc/u tế bào quanh mạch ở hệ thần kinh trung ương

Abstract

Solitary fibrous tumour and Hemangiopericytoma were once rare distinct mesenchymal tumour entities with suggested incidences of less than 1% of all central nervous system tumours. The current revised 4th edition WHO classification of tumours of the central nervous system published in 2016 has merged these two entities into a combined non-meningeal mesenchymal tumor nomenclature called Solitary fibrous tumour/Hemangiopericytoma. By definition, tumors with Solitary fibrous tumour phenotype are grade I while those with Hemangiopericytoma phenotype are graded as II or III. In this report, we described a case of Solitary fibrous tumour/Hemangiopericytoma, grade III in the left temporal lobe convexity, and reviewed the clinicopathological features. This is a 58-year-old female with a history of surgically removed atypical meningioma in 2014 and an ongoing chemoradiotherapy regimen of cervical squamous cell carcinoma since 2018. The initial clinical diagnosis was recurrent meningioma on the left cerebral convexity and the tumour was removed completely by surgery. Histopathologically, this was a spindle cell tumour type with a high proliferation rate (> 5 mitotic figures/10 hpf) and rich stromal dilated or staghorn-like blood vessels. Tumour necrosis was not found, however. On immunohistochemistry, tumour cells were positive for Stat6, Bcl2, Ki67 (15%) and negative for EMA, GFAP, CD31, CD34, SMA, S100, TLE1. Ultimately, a pathological diagnosis of Solitary fibrous tumour/Hemangiopericytoma, grade III was made according to the 2016 WHO classification.