Intracranial Hemangiopericytoma: Study of 12 Cases (original) (raw)

Intracranial Hemangiopericytoma—Our Experience in 30

2013

Meningeal hemangiopericytoma (HPC) is a rare, aggressive central nervous system tumor that tends to invade locally and to metastasize, and has a high rate of recurrence.This study presents a retrospective review of patients managed for intracranial HPC at Rome University Hospital.A total of 43 patients with intracranial HPC were treated from 1980 to 2010. Treatment and follow-up information was available for analysis on 36 patients. The median survival for all patients was 83.5 months after date of diagnosis, with 1-year, 5-year, and 10-year survival rates of 100%, 94.4%, and 72.2%, respectively. Eighteen patients (41.86%) had HPC recurrence. The median time until recurrence was 72.24 months, with 1-year, 5-year, and 10-year progression-free survival rates of 98%, 51%, and 29%, respectively. Five patients (11.62%) developed extracranial metastasis. Patients undergoing any form of adjuvant radiation treatment, including external beam radiotherapy, Gamma Knife radiosurgery, and/or proton beam therapy, had no longer median overall survival (OS) (178 vs. 154 months, respectively; P = .2); but did have a significantly improved recurrence-free interval (108 vs. 64 months; P = .04) compared with patients who did not undergo radiation treatment. Tumor characteristics associated with earlier recurrence included size ≥7 cm (log-rank, P < .05) and sinus invasion (log-rank, P < .05).Strategies combining adjuvant radiation with tumor resection seemed to hinder tumor progression, but had no effect on OS or the development of metastases. Greater extent of resection was associated with increased OS (log-rank, P < .05). Anaplastic HPC was associated with reduced OS and with reduced recurrence interval (log-rank, P < .05).

Meningeal Hemangiopericytoma of Brain: Role of Radiation Therapy

Online Journal of Health and Allied Sciences, 2013

Hemangiopericytoma is an uncommon vascular tumour. Complete surgical resection is treatment of choice. However, late local recurrences and distant extraneural metastases ranging from 12% to 57% are reported in literature after complete removal. Post operative radiotherapy is indicated in unresectable or incompletely excised tumour. We present a case of meningeal hemangiopericytoma in a 60 years old female patient treated with surgery and adjuvant radiotherapy. There is no evidence of disease at primary site and no sign or symptoms of metastatic disease in the patient after three years.

Management of intracranial meningeal hemangiopericytomas: outcome and experience

Neurosurgical Review, 2006

Hemangiopericytomas represent rare intracranial tumors that have a tendency to recur locally and have the unique characteristic of giving extracranial metastases. Our current communication reviews a series of patients diagnosed with hemangiopericytoma who were treated in our facility. Eleven patients with a mean age of 51.2 years underwent follow-up for a mean time of 7.1 years. Their neuroimaging preoperative evaluation included plain skull X-rays, head CT scans, brain MRI, angiograms, and (1)HMRS. Preoperative embolization of the tumor was employed in 6/11 patients. All patients underwent craniotomy for tumor resection and postoperative radiation treatment was employed on all but one. Grade I resection was accomplished in 6/11 (54.5%), grade III in 4/11 (36.4%), and grade IV in 1/11 (9.1%). Local recurrence was detected in 3/11 (27.3%) at a mean period of 5 (range 2-7.5) years. Extracranial metastatic disease was documented in 4/11 (36.4%) patients at a mean of 4.9 (range 2.5-7) years after the initial diagnosis. The GOS score was: 7/11 (63.6%) scored 5, while 4/11 (36.4%) died at a mean time of 5.5 (range 3-8) years after the initial diagnosis. Intracranial hemangiopericytomas management requires aggressive surgical resection, postoperative radiation treatment, and extensive follow-up to rule out local recurrences and delayed extracranial metastases.

Hemangiopericytoma in the central nervous system

Neurochirurgie, 2008

Most hemangiopericytomas (HPC) are located in the musculoskeletal system and the skin, while the location in the central nervous system (CNS) is rare. The latter represents 2 to 4% in large series of meningeal tumors, thus accounting for less than 1% of all CNS tumors. In the central nervous system, tumors with a hemangiopericytomatous histolopathological pattern can be either hemangiopericytomas or solitary fibrous tumors. CNS-HPCs have a relentless tendency for local recurrence and metastases outside the CNS. Metastasis can also appear many years after adequate treatment of the primary tumor.

Intraspinal Dissemination and Local Recurrence of an Intracranial Hemangiopericytoma

World Neurosurgery, 2018

BACKGROUND: Hemangiopericytomas (HPCs) are rare vascular tumors that resemble meningiomas on imaging and have a high rate of local recurrence and metastases. There remains a paucity of data to guide management decisions of intraspinal dissemination of HPC in the literature, and none specifically related to anaplastic HPCs. CASE DESCRIPTION: Case report of a 34-year-old female with locally and distantly recurrent anaplastic hemangiopericytoma (HPC) (WHO grade III). She initially presented with tinnitus in her right ear. A well-circumscribed, contrast-enhancing lesion was identified in the right cerebellopontine angle (CPA). Treatment consisted of a subtotal resection (STR) and postoperative radiation therapy (RT) to a dose of 60 Gy in 30 fractions. After a 3-year disease free interval, 7 lesions recurred intracranially and extracranially. The extracranial lesions were drop metastases of the original HPC through the CSF into the spinal canal. Of note, FDG PET/CT was not sensitive enough to detect these new lesions. The intracranial recurrence was on the edge of the prior radiotherapy field, representing a marginal failure having received <50 Gy. The intracranial recurrences were treated with salvage gamma knife stereotactic radiosurgery (SRS) with local control. She underwent intradural extramedullary hemilaminectomy of a thoracic spine metastasis followed by fractionated proton beam therapy (PBT) with a boost to unresected lesions. Within a few months of PBT she became pregnant. Pregnancy did not affect recurrence or ameliorate tumor growth. CONCLUSIONS: This case report discusses the role genetics, adjuvant RT, SRS, MRI, and PET played in this unique clinical scenario of anaplastic HPC.

Intracranial Hemangiopericytoma: A Case Report

İstanbul Tıp Fakültesi Dergisi, 2014

Meningeal hemangiopericytoma (HPC) originating from pericytes is a highly vascularised and a rare mesenchimal tumor that constitutes %0.4 of all primary central nervous system tumors. These tumors share common arachnoid location with benign meningioma and mimic meningiomas in clinical and radiographic presentation. Because of the aggressive nature of the central nervous system HPs with high recurrence and distal metastasis rates the first line treatment is total resection with close follow ups postoperatively. In this report we tried to analyse the differentiation of hematoma and recurrence and evaluated the role of radiotherapy in light of the current literature.

Adyuvant fractionated radiotherapy after resection of intracranial hemangiopericytoma

Reports of Practical Oncology & Radiotherapy, 2012

Background: Intracranial hemangiopericytoma (HPC) is an uncommon malignant vascular tumor arising from mesenchymal cells with pericytic differentiation. Surgery remains the mainstay treatment, and adjuvant radiation therapy appears to be appropriate for patients with high grade tumors or incomplete resection. We present our experience and review of the literature. Materials and methods: We describe two cases of intracranial hemangiopericytoma located in the frontal lobe of the CNS. Both patients underwent complete tumor resection followed by adjuvant fractionated radiotherapy and completed treatment without interruptions. Results: A local recurrence was observed in one of these cases and fractionated stereotactic radiotherapy was performed. Both patients are alive and disease has been under control up to date. Conclusion: The treatment of choice for intracranial hemangiopericytoma is a complete surgical resection as long as possible. Adjuvant radiotherapy of HPC can result in increased tumor control and should be considered as an effective treatment for patients with high grade or demonstrated residual tumor in the postoperative period. Salvage treatment using limitedfield fractionated radiotherapy for local recurrence treatment is considered an acceptable option.