Imaging assessment of tumor densities and sizes following pazopanib treatment for central nervous system solitary fibrous tumors with multiple extracranial metastases: A case series

Tsuno,Takaya; Masahira,Noritaka; Numoto,Kunihiko; Iwasa,Hitomi; Kagimoto,Nao; Yamasaki,Daichi; Kondo,Yuichiro; Matsuoka,Toshiki; Nishimura,Hiroyuki

doi:10.3892/ol.2024.14791

Imaging assessment of tumor densities and sizes following pazopanib treatment for central nervous system solitary fibrous tumors with multiple extracranial metastases: A case series

Authors:
- Takaya Tsuno
- Noritaka Masahira
- Kunihiko Numoto
- Hitomi Iwasa
- Nao Kagimoto
- Daichi Yamasaki
- Yuichiro Kondo
- Toshiki Matsuoka
- Hiroyuki Nishimura
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Affiliations: Department of Neurosurgery, Kochi Health Sciences Center, Kochi 781‑8555, Japan, Department of Neurosurgery, Hata Kenmin Hospital, Kochi 788‑0785, Japan, Department of Orthopedic Surgery, Kochi Health Sciences Center, Kochi 781‑8555, Japan, Department of Radiology, Kochi Health Sciences Center, Kochi 781‑8555, Japan, Department of Neurosurgery, Chikamori Hospital, Kochi 780‑8522, Japan
Published online on: November 6, 2024 https://doi.org/10.3892/ol.2024.14791
Article Number: 45
Copyright: © Tsuno et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Central nervous system (CNS) solitary fibrous tumors (SFTs) are rare but aggressive, often metastasizing to extracranial regions, with no established treatments apart from surgery. Pazopanib, a multikinase angiogenesis inhibitor, is used to treat extracranial SFTs; however, its efficacy for treating CNS SFTs remains unclear. To address this issue, the efficacy of pazopanib was investigated, focusing on tumor density and size in CNS SFTs with extracranial metastases after initiation, interruption or resumption of pazopanib treatment. The present study retrospectively reviewed 3 consecutive cases of CNS SFTs showing extracranial metastases that were referred to Kochi Health Sciences Center (Kochi, Japan) between January 2018 and April 2024 and were treated with pazopanib. All measurable lesions observed via contrast‑enhanced computed tomography (CT; 50 lesions) and magnetic resonance imaging (MRI; 21 lesions) were evaluated. Cases 2 and 3, meeting the Choi criteria, showed stable disease and achieved partial response after pazopanib initiation, respectively. In Case 1, both intracranial and extracranial tumor CT densities decreased after initiation and resumption of pazopanib treatment. However, both tumor CT sizes increased after interruption of pazopanib treatment. In Case 2, MRI revealed decreases and increases in the intracranial tumor size after initiation and interruption, respectively. Notably, pazopanib interruption caused rapid infratentorial tumor growth and death. Case 3 showed decreased extracranial tumor CT densities and sizes after pazopanib initiation, with pazopanib administered for 3.5 years. Thus, pazopanib may offer the potential to control both intracranial and extracranial tumors in patients with CNS SFTs with extracranial metastasis; however, treatment interruption requires careful consideration.

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