RT Journal Article SR Electronic T1 A meningeal myofibroblastic neoplasm related to solitary fibrous tumour and associated with a malignant neuroblastic element JF Journal of Clinical Pathology JO J Clin Pathol FD BMJ Publishing Group Ltd and Association of Clinical Pathologists SP 180 OP 183 DO 10.1136/jcp.2009.067678 VO 63 IS 2 A1 T S Bracey A1 D A Hilton A1 T Sulkin A1 M E F Smith YR 2010 UL http://jcp.bmj.com/content/63/2/180.abstract AB Background Solitary fibrous tumour (SFT) is a rare mesenchymal tumour now described at many locations, including the meninges. Intracranial SFT closely resembles meningioma clinically and radiologically, and, like meningioma, reports of meningeal SFT suggest a relatively benign behaviour after complete resection. Histopathological features distinguishing SFT from meningioma include variable cellularity, spindle cells arranged in fascicles, staghorn blood vessels and immunopositivity for CD34.Clinical presentation The case is reported of a 60-year-old man with an anterior cranial fossa meningeal-based mass, which was resected. Histology showed some features in common with SFT (variable cellularity, spindled morphology, CD34 expression), but included an epithelioid element with cytokeratin and desmin immunopositivity, and lacked the characteristic vascular pattern of SFT. Histological features of meningioma were lacking. Recurrence of the tumour with extracranial extension 9 years later resulted in death of the patient. Histological examination revealed similar biphasic epithelioid and spindled CD34-immunopositive appearance to the earlier tumour, but in addition showed a high-grade element resembling olfactory neuroblastoma.Conclusion This case report is of a meningeal-based mesenchymal neoplasm with histological similarities to SFT. Its morphology and immunophenotype, however, are distinct from SFT and hence it is proposed that it is a newly described entity. In addition, recurrence of the tumour with a high-grade neuroblastic element has, to our knowledge, not previously been described in SFT.