Clinicopathological, Radiological, and Prognostic Profile of Solitary Fibrous Tumor of Central Nervous System: A...

Solitary fibrous tumors (SFTs) are mesenchymal neoplasms, initially characterized as primary thoracic tumors, but now recognized to occur in various anatomical locations. Primary central nervous system (CNS) SFTs are relatively rarer CNS neoplasm's described towards the end of the last century. This study aims to comprehensively profile the clinicopathological, radiological, and prognostic characteristics of SFTs of the CNS. Given the absence of prior regional studies on CNS SFTs from North-East India, our objective was also to evaluate the overall survival outcomes along with other relevant findings in the affected patients. A retrospective review was conducted on cases histopathologically diagnosed and treated as CNS SFTs. Data pertaining to clinical presentation, imaging features, histopathology, and immunohistochemistry were systematically analyzed. Additionally, treatment modalities and follow-up outcomes were evaluated. Categorical variables were assessed using Fischer's exact test. A p-value < 0.05 was considered statistically significant. All statistical tests were two-sided. Our findings indicate that CNS SFTs predominantly occur as intracranial neoplasm in elderly female patients, most commonly presenting with headache. Radiologically, they exhibited a heterogeneous appearance on magnetic resonance imaging. Histologically, tumors demonstrated hemangiopericytoma-like features, while immunohistochemical analysis consistently revealed STAT6 positivity. Gross total resection followed by adjuvant radiotherapy significantly improved both progression-free survival and overall survival. While pre-operative clinical and radiological assessments provide important diagnostic clues for this rare CNS tumor, definitive diagnosis and accurate grading rely primarily on post-operative histopathological and immunohistochemical evaluation. The study underscores the importance of an integrated diagnostic approach to optimize patient outcomes in CNS SFTs.