Treatment of intracranial solitary fibrous tumor with stereotactic radiosurgery : a case report and review of literature

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 ; Background: Intracranial solitary fibrous tumors (SFT) are rare neoplasms of the brain with a typical benign and slow-growing behavior. The gold-standard of treatment is gross total resection (GTR). However, sometimes this approach is dangerous or not feasible because of anatomical considerations. Therefore, approaches like stereotactic radiosurgery (SRS) are currently being evaluated. Clinical Presentation: The authors present a 59-year-old male patient with a month history of language and humor disorders with headaches and right central facial paresis. Imaging studies revealed an anterior left temporal mass with edema and mass effect. GTR was performed, with histology revealing a SFT. During follow-up, regrowth with invasion of the left cavernous sinus and optical nerve compression was reported. Subtotal resection (STR) was performed leaving only an intracavernous sinus residue. Pathology once again was consistent with SFT. The tumor residue was treated with linear accelerator-based SRS. During follow-up a slow tumor regrowth was observed in the first 12 months after SRS, with posterior stabilization and shrinkage. The shrinkage was only observed 24 months post-SRS. Conclusion: our case represents the successful treatment of an SFT using SRS. It strengthens the role of SRS in managing these tumors when surgery is not an option. ; Introdução: os tumores fibrosos solitários intracranianos (TFS) são neoplasias raras do encéfalo com características benignas e crescimento lento. O tratamento principal passa pela ressecção total do tumor (RTT). No entanto, esta abordagem nem sempre é possível por condicionantes anatómicas. Assim, a radiocirurgia estereotácica (RCE) tem sido estudada como terapêutica adjuvante. Caso clínico: Os autores apresentam um doente de 59 anos, do sexo masculino, com história de alterações da linguagem e do humor, associadas a cefaleias e parésia facial central direita com a duração ...