European Radiology

, Volume 28, Issue 9, pp 3986–3995 | Cite as

Solitary fibrous tumour of the spine: imaging features of a commonly misdiagnosed entity

  • Ning LangEmail author
  • Enlong Zhang
  • Xiaoying Xing
  • Huishu YuanEmail author



Solitary fibrous tumours (SFTs) occurring in the spine are rare. Herein, we review the clinical and imaging data of spinal SFT.


We retrospectively analysed eight cases of pathologically confirmed spinal SFT imaging and clinical data, pathological manifestations, surgical methods, and follow-up results.


Five SFTs cases occurred in the cervical spine, two in the thoracic spine, and one in the lumbosacral spine. Five cases showed a dumbbell-shaped or lobulated soft tissue mass that grew across the intervertebral foramen, two cases showed an expansive intraosseous mass formation in the vertebral body and/or posterior element, and one case showed a long-spindle shaped intraspinal canal mass growing along the spinal canal. Seven caused local invasion and destruction of the vertebral body and posterior element. Benign SFTs displayed a good prognosis, whereas malignant SFTs were prone to recurrence and metastasis (3/4).


Spinal SFTs are difficult to characterise with imaging and required pathological and immunohistochemical investigation. Prolonged follow-up is recommended once a diagnosis of spinal SFTs has been established because of the unclear biology.

Key Points

• Spinal solitary fibrous tumours are extremely rare.

• SFTs should be showed the differential of masses developing though the foramen.

• Combing imaging with pathology and immunochemistry assesses the diagnosis and establish nature.


Tomography X-ray computed Magnetic resonance imaging Solitary fibrous tumours Spine 



Computed tomography


Clinical tumour volume


Gross total resection


Gross tumour volume


High-power fields


Magnetic resonance


Planning gross tumour volume


Planning target volume


Solitary fibrous tumour


T1-weighted imaging


T2-weighted imaging



This study has received funding by National Natural Science Foundation of China (81701648) and Beijing Municipal Natural Science Foundation (7164309) and National Natural Science Foundation of China(81471634).

Compliance with ethical standards


The scientific guarantor of this paper is professor Min-Ying Su. 164 Irvine Hall, Center for Functional Onco-Imaging, University of California, Irvine,CA 92697-5020. E-mail:

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Diagnostic or prognostic study

• Performed at one institution


  1. 1.
    Klemperer PRC (1931) Primary neoplasms of the pleura: report of five cases. Arch Pathol (Chic) 11:385–412Google Scholar
  2. 2.
    Wushou A, Jiang YZ, Liu YR et al (2015) The demographic features, clinicopathologic characteristics, treatment outcome and disease-specific prognostic factors of solitary fibrous tumor: a population-based analysis. Oncotarget 6:41875–41883CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Carneiro SS, Scheithauer BW, Nascimento AG et al (1996) Solitary fibrous tumor of the meninges: a lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study. Am J Clin Pathol 106:217–224CrossRefPubMedGoogle Scholar
  4. 4.
    Albert GW, Gokden M (2017) Solitary fibrous tumors of the spine: a pediatric case report with a comprehensive review of the literature. J Neurosurg Pediatr 19(3):339–348CrossRefPubMedGoogle Scholar
  5. 5.
    Brigui M, Aldea S, Bernier M et al (2013) Two patients with a solitary fibrous tumor of the thoracic spinal cord. J Clin Neurosci 20(2):317–319CrossRefPubMedGoogle Scholar
  6. 6.
    Son S, Lee SG, Jeong DH et al (2013) Malignant solitary fibrous tumor of tandem lesions in the skull and spine. J Korean Neurosurg Soc 54(3):246–249CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Tsutsumi N, Kojima Y, Nishida K et al (2014) Surgical treatment for recurrent solitary fibrous tumor invading atlas. Head Neck 36(11):E121–E124CrossRefPubMedGoogle Scholar
  8. 8.
    Bruder M, Tews D, Mittelbronn M et al (2015) Intramedullary Solitary Fibrous Tumor--A Benign Form of Hemangiopericytoma? Case Report and Review of the Literature. World Neurosurg 84(1):187–189CrossRefGoogle Scholar
  9. 9.
    Fargen KM, Opalach KJ, Wakefield D et al (2011) The central nervous system solitary fibrous tumor: a review of clinical, imaging and pathologic findings among all reported cases from 1996 to 2010. Clin Neurol Neurosurg 113(9):703–710CrossRefPubMedGoogle Scholar
  10. 10.
    Hirakawa A, Miyamoto K, Hosoe H et al (2004) Solitary fibrous tumor in the occipitocervical region: a case report. Spine (Phila Pa 1976) 29(23):E547–E550CrossRefGoogle Scholar
  11. 11.
    Magro G, Bisceglia M, Michal M et al (2002) Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept. Virchows Arch 440(3):249–260CrossRefPubMedGoogle Scholar
  12. 12.
    Schweizer L, Koelsche C, Sahm F et al (2013) Meningeal hemangiopericytoma and solitary fibrous tumors carry the NAB2-STAT6 fusion and can be diagnosed by nuclear expression of STAT6 protein. Acta Neuropathol 125(5):651–658CrossRefPubMedGoogle Scholar
  13. 13.
    Yokoi T, Tsuzuki T, Yatabe Y et al (1998) Solitary fibrous tumour: significance of p53 and CD34 immunoreactivity in its malignant transformation. Histopathology 32(5):423–432CrossRefPubMedGoogle Scholar
  14. 14.
    Munoz E, Prat A, Adamo B et al (2008) A rare case of malignant solitary fibrous tumor of the spinal cord. Spine (Phila Pa 1976) 33(12):E397–E399CrossRefGoogle Scholar
  15. 15.
    Aftab S, Casey A, Tirabosco R et al (2010) Fat-forming solitary fibrous tumour (lipomatous haemangiopericytoma) of the spine: case report and literature review. Skeletal Radiol 39(10):1039–1042CrossRefPubMedGoogle Scholar
  16. 16.
    Kim KA, Gonzalez I, McComb JG et al (2004) Unusual presentations of cerebral solitary fibrous tumors: report of four cases. Neurosurgery 54(4):1004–1009CrossRefPubMedGoogle Scholar
  17. 17.
    Miyashita K, Hayashi Y, Fujisawa H et al (2004) Recurrent intracranial solitary fibrous tumor with cerebrospinal fluid dissemination. Case report. J Neurosurg 101(6):1045–1048Google Scholar
  18. 18.
    Farooq Z, Badar Z, Zaccarini D et al (2016) Recurrent solitary fibrous tumor of lumbar spine with vertebral body involvement: imaging features and differential diagnosis with report of a case. Radiol Case Rep 11(4):450–455CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ginat DT, Bokhari A, Bhatt S et al (2011) Imaging features of solitary fibrous tumors. AJR Am J Roentgenol 196(3):487–495CrossRefPubMedGoogle Scholar
  20. 20.
    Mariniello G, Napoli M, Russo C et al (2012) MRI features of spinal solitary fibrous tumors. A report of two cases and literature review. Neuroradiol J 25(5):610–616CrossRefPubMedGoogle Scholar
  21. 21.
    Chick JF, Chauhan NR, Madan R (2013) Solitary fibrous tumors of the thorax: nomenclature, epidemiology, radiologic and pathologic findings, differential diagnoses, and management. AJR Am J Roentgenol 200(3):W238–W248CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologyPeking University Third HospitalBeijingPeople’s Republic of China
  2. 2.Department of RadiologyPeking University International HospitalBeijingPeople’s Republic of China

Personalised recommendations