Recurrence of Solitary Fibrous Tumor in the Spinal Cord Following Gross Total and Subtotal Resection: A Case Report of Recurrence 19 Years of Post-total Resection and Systematic Literature Review.

Abstract

Spinal cord solitary fibrous tumors (SFTs), previously known as hemangiopericytoma (HPC), represent exceedingly rare neoplasms. Strategies for their management, such as appropriate follow-up duration, remain controversial due to their propensity for recurrence despite extended periods of quiescence. We report a 51-year-old male presenting with new-onset back pain and gait disturbances, who had undergone gross total resection (GTR) of an SFT within the thoracic spinal cord 19 years ago. Magnetic resonance imaging of the thoracic spine revealed recurrent tumors at the T7 level within the spinal cord. Subsequent resection achieved GTR. A comprehensive literature review was undertaken to assess the benefits of different resection extents (gross total removal (GTR) vs. subtotal removal (STR)), adjuvant radiation therapy, and the optimal duration of postoperative follow-up. Since 1960, 46 cases, including the present one, have reported recurrent spinal SFT/HPC following GTR and STR. Statistical analyses demonstrated that neither the type of resection nor adjuvant radiation therapy significantly impacted median recurrence-free survival in this cohort. Given their unpredictable behavior, meticulous lifelong follow-up following successful resection appears crucial for managing these tumors effectively.