Dorsal spine intradural extramedullary hemangiopericytoma: a case report (original) (raw)
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How to differentiate spinal cord hemangiopericytoma from common spinal cord tumor?
Neurochirurgie, 2020
Introduction.-Tumors of the spinal cord are rare and some can be confused with each other. We report a rare spinal cord solitary fibrous tumor/hemangiopericytoma (SFT/HPC), and propose keys to differentiate spinal cord tumors from each other. Case report.-A 67-year-old man presented weakness with recent diffuse sensory disorders in the right lower limb. Spinal MRI revealed a T8-T9 intradural extramedullary mass with spinal cord compression. Gross total resection of a poorly vascularized intradural tumor was achieved. It was an encapsulated extramedullary tumor, which was difficult to separate from the spinal cord due to the presence of pial adhesions. Definitive diagnosis was grade 1 SFT/HPC of the spinal cord. One-year follow-up MRI revealed complete excision without any evidence of residual tumor. Conclusion.-SFT/HPC is a very rare spinal tumor that can be extramedullary, intramedullary or both. It may perfectly mimic meningioma. The maximal resection is the best treatment, but can be challenging because of the tumor's firm consistency and pial adherences to the spinal cord. Outcome is good in case of gross total resection, but there is a risk of very late recurrence, requiring long-term follow-up.
Intradural Hemangiopericytoma of the Lumbar Spine: A Rare Entity
American Journal of Neuroradiology, 2008
We report a case of a patient with an intradural hemangiopericytoma of the lumbar spine and the unusual MR angiography (MRA) and spinal angiography findings of arteriovenous shunting with spinal venous congestion. We highlight the concordance of the unusual MRA and angiographic findings and their relationship to combined endovascular and surgical therapy.
Primary Intradural Hemangiopericytoma With Intramedullary Invasion
Journal of the Chinese Medical Association, 2009
Hemangiopericytoma (HPC) is a rare tumor of the central nervous system and is usually found intracranially. Intraspinal HPCs are very rare and mostly involve the extradural bony structures. Primary intradural HPC has only been reported in 10 cases, all of which occurred in the extramedullary region. Intramedullary invasion has never been reported. Here, we describe a case of primary intradural HPC of the thoracic spine that presented initially with paresthesia and paraplegia of both legs. Magnetic resonance imaging of the thoracic spine showed an intradural dumbbell-shaped tumor at the T10 level. The initial impression was neurogenic tumor, meningioma, or metastasis. During operation, the tumor was found to have obvious intramedullary invasion. Gross-total removal was done, and the patient's neurological function improved; there was no recurrence at the 3-year follow-up. There is no consensus as to what constitutes the optimal treatment of HPC, but most neurosurgeons will advocate gross-total resection. A comparative analysis between intradural and extradural HPCs showed a higher chance of gross-total resection for intradural HPCs, while the recurrence rates showed no difference. The role of adjuvant radiotherapy remains uncertain. Due to the high risk of recurrence and metastasis of HPCs, close follow-up for a long period is mandatory. [
Extra and intradural spinal Hemangioblastoma
Coluna/Columna, 2012
Hemangioblastomas of the central nervous system (CNS) are low-grade highly vascularized tumors that may be sporadic or associated with Von Hippel-Lindau disease. Extradural hemangioblastomas are uncommon and those located extra and intradurally are even rarer. This study uses an illustrative case and literature review to discuss the difficulties to consider the correct diagnosis and to select the best surgical approach. A 57 years-old white male patient presented with myelopathy and right C5 radiculopathy. The images showed a lobulated, hourglass shaped, highly enhanced extra/intradural lesion that occupied the spinal canal and widened the C4-C5 right intervertebral foramen. Total resection of the intradural lesion was achieved through a posterior approach, but the extradural part could only be partially removed. Complete improvement was observed after four months of follow-up and the residual tumor has been followed up clinically and radiologically. Even though the preoperative imp...
Primary epidural hemangiopericytoma of thoracic spine: A case report
2010
Introduction: Haemangiopericytomas are rare CNS tumours. Till date only 39 cases of the tumour in the spine have been reported. Design of study: To report a case of thoracic epidural haemangiopericytoma. Clinical data: 67 years old male presented with backpain and progressive weakness of both lower limbs and difficulty in passing urine. Presentation: Spastic paraplegia with some sensory loss below D10 level. Investigations: MRI showed collapse of body of D7 with soft tissue in paraspinal muscles. Cord was compressed. It was hypointense on T1 and hyperintense with T2 and enhancing with contrast. Surgery: The tumour was excised by lateral cavitory approach. It was soft, grey and vascular. Post op: Improvement in power to 3/5 within 7 days. Histopathology: Highly cellular, ascular mesenchymal tumour. Vascular spaces in staghorn pattern and cellular proliferation around branched vessels. Spindle shaped cells with eosinophilic cytoplasm and oval nuclei were seen. Silver staining displayed fibers around cells. Cells were diffusely positive for vimentin staining and negative for CD34, desmin, s-100, smooth muscle actin and epithelial membrane antigen. Endothelial cells were highlighted by CD34 immunostaining.
Turkish Neurosurgery, 2020
AIM: Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are rare nonmeningothelial mesenchymal tumors sharing fusion of NGF1-A binding protein 2 (NAB2) and signal transducers and activators of transcription (STAT6). The WHO classification of central nervous system (CNS) tumors (2016) highlights that molecular confirmation of NAB2/STAT6 fusion or immunohistochemical nuclear expression of STAT6 is mandatory for the diagnosis of SFT/HPC.Herein, we present a series of four cases of SFT/HPC of the brain, which mimicked other CNS tumors both clinically and radiologically. MATERIAL and METHODS: This is a retrospective study over a period of two and a half years. Out of the 156 operated cases of brain tumors, four patients (2.56%) were diagnosed with SFT/HPC. The clinicoradiological details with the surgical procedure were retrieved from the archived hospital records. RESULTS: All cases were males, of which three were in their 5 th decade while one was a 14-month-old baby. Two cases were primary and the rest were recurrent. The location of tumors was extra-axial left cerebellotentorial, clivaldural-based, left cerebellar, and in the left frontoparietal region, respectively. The clinical impression was meningioma in three cases, while it was primitive neuroectodermal tumor (PNET) /atypical teratoid/rhabdoid tumor (ATRT) in one case. With the detailed histomorphology and immunohistochemistry, the final diagnosis was anaplastic hemangiopericytoma (WHO grade III) for all the cases. During our followup, one patient died with the disease, while the rest are doing well. CONCLUSION: SFT/HPC should be kept in the differential diagnosis of all dura-based hypervascular masses, especially in recurrent cases, due to its aggressiveness and high recurrence rate.
Intradural Extramedullary Hemangioblastoma Differentiated by MR Images in the Cervical Spine
Journal of Spinal Disorders & Techniques, 2004
We report a rare case of hemangioblastoma existing in the intradural extramedullary location diagnosed by magnetic resonance imaging (MRI) examination alone. A 46-year-old man gradually developed numbness in his lower extremities. MR images revealed a tumor shadow located posterior to the spinal cord at C5-C7. Small signal void shadows were continuously observed from C1 to C5 in the region cranial to the tumor, indicating the presence of enlarged vessels. Under microscopic observation, the tumor with accompanying vessels was resected totally via hemilaminectomy. The postoperative course was uneventful, and MR images obtained 4 months after the operative procedure demonstrated total removal of the tumor and the abnormal vessels. In this case, recognizing the abnormally enlarged vessels outside the tumor mass preoperatively led us to the correct diagnosis on MR images.