The First Reported Case of a Hemorrhagic Solitary Fibrous Tumor at the Cerebellopontine Angle Successfully Managed with Multimodal Therapy.

Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, and cases of tumor bleeding are rarely seen. While radiographically similar to meningioma, SFTs exhibit a more aggressive clinical course. The mainstay of treatment is surgical resection followed by adjuvant radiotherapy. We present the first case of a hemorrhagic SFT located at the cerebellopontine (CP) angle, which was successfully treated with multimodal therapy. A 31-year-old man presented with a headache and altered consciousness. Neuroimaging revealed a large dural-based tumor at the left CP angle with subdural hematoma (SDH). The patient underwent preoperative endovascular embolization and near-total surgical resection. Further histopathological analysis confirmed the diagnosis of intracranial SFT. The patient recovered favorably and underwent adjuvant gamma-knife stereotactic radiosurgery (SRS) for the residual tumor. To the best of our knowledge, this is the first reported case of a hemorrhagic SFT treated with a combination of preoperative endovascular embolization and adjuvant SRS. This case illustrates that tailored multimodal treatment is both effective and safe for managing hemorrhagic intracranial SFTs.