# Intracranial Solitary Fibrous Tumor: A Case of a 21-Year-Old Male With Olfactory Hallucination

## TL;DR

A 21-year-old man presented with unusual symptoms and was diagnosed with a rare brain tumor, highlighting the importance of accurate diagnosis.

## Contribution

This case report presents a rare instance of intracranial SFT in a young patient with unique symptoms.

## Key findings

- The patient exhibited olfactory hallucinations and dysautonomia as part of focal seizure features.
- The tumor was initially misdiagnosed as meningioma but was confirmed as SFT post-surgery.
- The case adds to the limited literature on young patients with intracranial SFT.

## Abstract

Meningeal solitary fibrous tumors (SFTs) are a rare central nervous system neoplastic process, resulting in frequent misdiagnosis as meningioma prior to pathologic analysis. Appropriate diagnosis is essential to lowering morbidity and mortality, as Grade II or III SFTs are aggressive neoplasms that possess metastatic potential. The existing data may suggest that intracranial SFTs primarily afflict those in their fourth through sixth decades of life. However, we present the case of a patient outside this demographic presenting with symptoms that we were unable to identify in any prior reports. A 21-year-old male in the United States Navy presented to the emergency department (ED) with a two-month history of progressive headaches, leading to nausea and emesis. The patient also endorsed a daily incidence of the same olfactory hallucination followed by several minutes of palpitations, flushing, and dizziness. His neurologic exam was unremarkable, but imaging in the ED revealed a large mass abutting the right medial sphenoid wing. The radiographic appearance of the mass with a dural tail led to a preoperative diagnosis of meningioma. However, pathologic analysis following gross total resection identified the mass as an SFT. A brief literature review complementary to this case underscored the high variability of intracranial SFT case presentations with a relative scarcity of epidemiologic data due to rarity. This review identified that it was common to initially diagnose SFTs as meningioma, similar to this particular case. This emphasizes the importance of an appropriate pathologic diagnosis. This case adds to the existing literature as anecdotal evidence of SFT occurring in a young patient and a unique symptom profile most notable for olfactory hallucination and dysautonomia as features of focal seizure.