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J Neurol Surg Rep 2014; 75(02): e214-e216
DOI: 10.1055/s-0034-1387196
Case Report
Georg Thieme Verlag KG Stuttgart · New York

A Case of Stereotactic Radiation in Skull Base Solitary Fibrous Tumor: More Harm Than Good?

Peter L. Santa Maria
1   Department of Otolaryngology, Head and Neck Surgery, Stanford University Hospital and Clinics, Stanford, California, United States
,
Waleed M. Abuzeid
1   Department of Otolaryngology, Head and Neck Surgery, Stanford University Hospital and Clinics, Stanford, California, United States
,
Jayakar V. Nayak
1   Department of Otolaryngology, Head and Neck Surgery, Stanford University Hospital and Clinics, Stanford, California, United States
,
Steven D. Chang
2   Department of Neurosurgery, Head and Neck Surgery, Stanford University Hospital and Clinics, Stanford, California, United States
,
Nikolas H. Blevins
1   Department of Otolaryngology, Head and Neck Surgery, Stanford University Hospital and Clinics, Stanford, California, United States
› Author Affiliations
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Publication History

15 March 2014

08 June 2014

Publication Date:
11 August 2014 (online)

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Abstract

Objective Due to its location, total resection of a skull base solitary fibrous tumor (SFT) can lead to morbidity with injury to lower cranial nerves, and a decision must be made between subtotal resection with possible stereotactic radiotherapy or total resection with cranial nerve morbidity. We report the long-term outcomes and review the literature of a case of stereotactic radiation in SFT to provide evidence for making this decision.

Design A retrospective case review.

Setting An academic tertiary referral center.

Results We present a case with > 10 years follow-up of radiation following skull base SFT, initially misdiagnosed as schwannoma, where radiotherapy did not improve recurrence or metastatic behavior and led to complications during subsequent surgical resection.

Conclusions SFT often masquerades as schwannoma, especially in the skull base. Careful immunohistochemistry, including CD34 expression, is critical to the diagnosis and management. This case highlights that total tumor resection of SFT remains the gold standard of treatment. Stereotactic radiation is not recommended in the management of skull base SFT.

Keywords

solitary fibrous tumor - stereotactic radiation
 

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