Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 631-642
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.631
Malignant solitary fibrous tumor in the central nervous system treated with surgery, radiotherapy and anlotinib: A case report
Dong-Yong Zhang, Lan Su, Yi-Wei Wang
Dong-Yong Zhang, Department of Neurosurgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Lan Su, Department of Genetron Health, Genetron Health, Beijing 110024, China
Yi-Wei Wang, Department of Anatomy, Shenyang Medical College, Shenyang 110034, Liaoning Province, China
Author contributions: Zhang DY drafted the manuscript and prepared the figures; Su L drafted the global landscape; Wang YW analyzed the immunohistochemical results and reviewed the manuscript; all authors read and approved the final manuscript.
Informed consent statement: This case was reported with consent from the patient’s parents. Informed consent for treatment was obtained from the patient’s parents.
Conflict-of-interest statement: The authors declare that they have no competing interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Yong Zhang, PhD, Doctor, Department of Neurosurgery, the First Affiliated Hospital of China Medical University, Heping District, Shenyang 110001, Liaoning Province, China. zhangdongyong@cmu.edu.cn
Received: May 3, 2021
Peer-review started: May 3, 2021
First decision: October 16, 2021
Revised: November 1, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: January 14, 2022
Processing time: 253 Days and 23.4 Hours
Abstract
BACKGROUND

Solitary fibrous tumor (SFT) of the central nervous system is rare. It is predominantly benign and rarely malignant. There is no established standardized treatment regimen for malignant intracranial SFTs.

CASE SUMMARY

We present a rare case of SFT in a 9-year-old girl with a space-occupying effect in the frontal-parietal lobes. She underwent craniotomy, and the mass was resected. Immunohistochemistry examination of the specimen showed that Ki-67 proliferation index staining was highly positive in 80% of tumor cells. Whole exome sequencing of the surgical tissue showed 38 somatic gene mutations and 1 gene amplification such as fibroblast growth factor receptor 4 or TP53. At 1.5 mo after surgery, head magnetic resonance imaging revealed that the tumor had recurred. The patient received 60 Gy and 30 fractions of intensity modulated radiotherapy. The patient then received anlotinib 8 mg po qd for 1-14 d of a 21 d cycle. Following this regimen, the patient achieved stable disease for > 17 mo. Magnetic resonance imaging at 1.5 year after surgery showed that the tumor had not progressed.

CONCLUSION

This is the first reported case of SFT of the central nervous system treated with surgery, radiotherapy and anlotinib. This regimen may be an effective treatment option for malignant intracranial SFT patients.

Keywords: Anlotinib; Biological therapy; Mutation; Recurrence; Sequence analysis; Case report

Core Tip: Solitary fibrous tumor (SFT) of the central nervous system is rare. There is no established standardized treatment regimen for malignant intracranial SFTs. This is the first reported case of SFT in the central nervous system treated with surgery, radiotherapy and anlotinib. This treatment regimen might be an effective treatment option for malignant intracranial SFT patients.