Intracranial Solitary Fibrous Tumor of the Skull Base: Two Cases and Systematic Review of the Literature.

BACKGROUND: Intracranial solitary fibrous tumors (ISFTs) are rare neoplasms of mesenchymal origin that originate from the meninges. ISFTs of the skull base can be challenging to treat as resection can be complicated by skull base anatomy. CASE DESCRIPTION: We present two cases of ISFT, the first presenting with compressive cranial neuropathy from Meckel's cave involvement and the second a posterior fossa lesion causing symptomatic hydrocephalus. METHODS: A systematic review was performed according to PRISMA guidelines. The PubMed database was queried with title/abstract keywords "intracranial," "solitary fibrous tumor," "hemangiopericytoma," "SFT," and "HPC." Search results were then reviewed to exclude cases not involving the skull base. References for all search-selected articles were reviewed for potential additional cases. Patient demographic and clinical data from 58 identified skull base cases were collected for qualitative synthesis. RESULTS: Visual disturbances were the most common presenting symptom (30 cases, 52%) followed by headache (22 cases, 38%). Most common site of involvement was the sellar/parasellar region (18 cases, 31%), followed by middle fossa/temporal bone (14 cases, 24%). Resection was performed in 55 cases with gross total resection reported in 26 cases (45%) and subtotal resection in 21 cases (36%). Tumor recurrence was documented in 15 cases (26%) with median and mean follow-up periods of 16 and 29.9 months, respectively. CONCLUSIONS: We discuss presentation, imaging, histopathology, and management considerations for ISFT while highlighting the potentially complex nature of skull base lesions and the need for multidisciplinary approach to treatment.