Left Parasagittal Solitary Fibrous Tumor Presenting With Lumbar Radiculopathy-Like Symptoms: A Case Report.

BACKGROUND

Lumbar radiculopathy is typically attributed to degenerative spinal disease, but central lesions can rarely mimic its sensory and motor features. Parasagittal tumors involving the motor and sensory leg regions may present with contralateral weakness, paresthesia, or pain that can be mistaken for peripheral pathology.

CASE REPORT: A 60-year-old man with chronic postoperative lumbar symptoms developed progressive bilateral leg weakness, worsening pain, and new right arm shaking. Lumbar imaging showed no clear correlate, but brain magnetic resonance imaging revealed a large left parasagittal solitary fibrous tumor compressing the leg motor-sensory cortices. Following craniotomy and adjuvant radiation, he experienced marked improvement in strength, sensation, and functional mobility, supporting a cortical source for symptoms previously attributed to radiculopathy.

CONCLUSIONS

Persistent radicular-like symptoms unresponsive to spinal intervention should prompt evaluation for central causes, especially when new upper motor neuron signs or multifocal deficits emerge.