
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.119
vdae090.119
Final Category: Spinal Cord Metastases
AcademicSubjects/MED00300
AcademicSubjects/MED00310
SPCM-05 SPINAL EPITHELIOD SOLITARY FIBROUS TUMOR METASTATIC TO THE 4TH VENTRICLE
Wang Ryan Western University, London, ON, Canada

Pejhan Shervin Western University, London, ON, Canada

Ang Lee-Cyn Western University, London, ON, Canada

Megyesi Joseph Western University, London, ON, Canada

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i36i36
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

Twenty-four years prior to his current presentation, a 76 year old man underwent resection of a solitary fibrous tumor from the lower cervical spinal cord (C5-C7) (called hemangiopericytoma at that time). He had been treated with radiotherapy. His current symptoms included headache and gait ataxia. Neuroimaging revealed a 4th ventricular tumor with mild hydrocephalus. He underwent a suboccipital craniectomy and resection of the 4th ventricular tumor. Pathology showed a hypercellular tumor composed of epitheliod cells with eosinophilic cytoplasm and moderately pleomorphic enlarged oval nuclei containing finely dispersed chromatin and prominent eosinophilic nucleoli in some nuclei. The tumor cells were arranged in nests and sheets separated by thin walled branching to thick walled hyalinized vessels with frequent areas of hemorrhage. Tumor cells showed high mitotic activity (about 8 mitoses/mm squared). The majority of tumor cells were positive for CK7, synaptophysin, E-cadherin, and rarely for CK20 and D2-40. Tumor cells were negative for EMA, transthyretin, myogenin, desmin, progesterone receptor, NeuN, Olig-2, TTF-1, GATA3, PAX8, OCT3/4, SALL4, CD117, S100 and GFAP. Vasculature was highlighted by PAS, reticulin, CD31, ERG, and CD34. INI-1 was intact in the nuclei. Final diagnosis was epitheliod solitary fibrous tumor, at least CNS WHO grade 2. This was consistent with the pathology from 24 years prior. Solitary fibrous tumor is known for recurrence and metastasis a long time after initial diagnosis. However, this case highlights the delayed metastatic spread of a relatively rare subtype of solitary fibrous tumor (epitheliod) to rare location (intraventricular, specifically the 4th ventricle). The literature will be reviewed.
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