Solitary fibrous tumor of the spinal nerve rootlet - Report of a case mimicking schwannoma

We report a case of solitary fibrous tumor involving the spinal nerve root at the L1-L2 level in a 67-year-old man. The patient presented with lumbar pain and weakness in his right lower extremity. Histologically, the tumor was composed of a proliferation of monomorphous spindle cells in an abundant collagenous stroma; neither necrosis nor mitoses were evident. These cells were strongly immunoreactive with CD34, Bcl-2, CD99, and vimentin, but were negative with S100 protein, smooth muscle actin, and epithelial membrane antigen. Such an immunohistochemical profile was consistent with a solitary fibrous tumor of the spinal nerve rootlet and ruled out the main differential diagnoses, schwannoma and meningioma. The present case suggests that solitary fibrous tumor should be considered in differentiating spindle cell lesions of the spinal cord and nerve rootlet.