Case Report of a Rare Solitary Fibrous Tumor of the Sacral Bone

This case study describes the treatment of a rare, large solitary fibrous tumor in the sacral bone of a 31-year-old woman. The patient experienced bilateral hip and lower back pain, along with unilateral root symptoms. The treatment involved imaging diagnostics, biopsy, preoperative endovascular embolization, tumor resection, and lumbosacral fusion. The tumor, measuring 12.0 x 10.0 x 9.3 cm, was successfully removed with clear margins, and the sacral bone defect was filled with an autograft and bone substitute. Post-treatment, the patient's neurological symptoms resolved, and she maintained good postoperative functionality, remaining in remission for over four years without adjuvant radiotherapy to preserve reproductive potential. The study concludes that pre-surgical embolization should be considered due to the hypervascular nature of these tumors, and a two-stage resection approach may yield better functional outcomes. Long-term patient monitoring is necessary due to the poorly understood clinical behavior and potential for late malignant recurrence.