Background: Solitary fibrous tumors (SFTs) are rare tumors derived from mesenchymal tissues. Notably, despite the widespread reports of SFT in various parts of the body, it is extremely rare in the spine, especially the lumbosacral spine, with only 4 previously reported cases.
Case presentation: A 40-year-old Chinese man had experienced low back and right leg pain for 11 years. Magnetic resonance imaging of the lumbar spine indicated a dumbbell-shaped mass at the right L4 vertebra. After the first surgical resection, the tumor was diagnosed as schwannoma pathologically. Three years later, he presented with low back pain, numbness in both legs, and defecation incontinence. Imaging examination suggested tumor recurrence. Pathologic examination of the second surgical specimen revealed features of SFT. So far, the patient has recovered well through the second extended resection and postoperative radiotherapy.
Conclusion: To our knowledge, this is the fifth reported case of lumbar spine SFT, and its diagnosis is a difficult challenge. However, accurate diagnosis and complete resection of SFT in a patient suspected of having SFT could extend life or improve quality of life.
Keywords: Immunohistochemistry; Schwannoma; Solitary fibrous tumor; Spinal canal.
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