Malignant Solitary Fibrous Tumor of Tandem Lesions in the Skull and Spine

A solitary fibrous tumor (SFT) is a rare neoplasm originated from the pleura, but they can occur in a variety of extrathoracic regions. Although many cases of primary SFT have been reported, there are extremely rare repots to date of a malignant SFT in the spine or skull. A 54-year-woman visited our hospital due to low back pain and both leg radiating pain. Several imaging studies including magnetic resonance imaging and computed tomography revealed expansive enhanced lesions in the occipital bone, T8, S1-2, and ilium, with neural tissue compression. We performed surgical resection of the tumor in each site, and postoperative radiosurgery and chemotherapy were performed. However, after six months, tumors were recurred and metastasized in multiple regions including whole spine and lung. The authors report here the first case of patient with malignant SFT of tandem lesions in the various bony structures, including skull, thoracic spine, and sacral spine, with a rapid recurrence and metastasis. Although malignant SFT is extremely rare, it should be considered in the differential diagnosis and carful follow-up is needed.