Haemangiopericytoma: current status, diagnosis and management

doi:10.1016/S0748-7983(97)90534-5

European Journal of Surgical Oncology (EJSO)

Volume 23, Issue 4, August 1997, Pages 282-285

https://doi.org/10.1016/S0748-7983(97)90534-5 Get rights and content

Haemangiopericytoma (HPC) is a rare tumour, characterized by unidentifiable light microscopic features. Despite first being described over 50 years ago, nothing much was known about this tumour until the early 1980s, when ultrastructural studies and tumour markers made it possible to differentiate it from other mesenchymal tumours. Advancements in radiology and the emergence of MRI technology helped surgeons in better planning. Pre-operative vascular embolization helped to reduce the menace of operative haemorrhage. Improvements in localization and delivery of radiotherapy, coupled with early diagnosis, has tremendously improved the treatment outcome of haemangiopericytoma.

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Microsurgical intracranial hypervascular tumor resection immediately after endovascular embolization in a hybrid operative suite: A single-center experience
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Citation Excerpt :
Surgical management of intracranial hypervascular tumors has always been a substantial challenge to neurosurgeons because of intractable intraoperative bleeding, which leads to decreased tumor resection rates and increased postoperative neurological deficits [1–5].
This study was performed to investigate the safety and outcome of one-stage hybrid endovascular and microsurgical treatment of intracranial hypervascular tumors.
The blood supply of the tumor was endovascularly embolized just before microsurgery in a one-stage fashion. Clinical data regarding the preoperative neurological status, tumor characteristics, hybrid treatment details and complications, intraoperative blood loss, and postoperative outcomes were collected prospectively and then analyzed.
Beginning in July 2016, 13 patients (5 women, 8 men) with intracranial hypervascular tumors were enrolled in this study, with a mean age of 48.2 ± 10.9 years. The patients’ tumors comprised seven hemangioblastomas, three hemangiopericytomas, two meningiomas, and one mesenchymal chondrosarcoma. The mean maximum tumor diameter was 54.9 ± 21.5 mm. No major procedural complications occurred except catheterization-related bleeding in one patient. The mean percentage of tumor devascularization was 65.0%±17.5%. Gross total resection was achieved in 12 patients (92.3%). The mean blood loss volume during microsurgical resection was 703.8 ± 886.8 mL (range, 150–3600 mL). Symptoms improved in three patients and remained stable in six patients.
One-stage hybrid embolization before intracranial hypervascular tumor resection is a safe and effective procedure to decrease intraoperative blood loss. It can prevent or treat embolization-related complications in a timely manner and avoid the risk of multiple surgical procedures.
Multifocal hepatic cystic mass as first manifestation of metastatic spinal hemangiopericytoma
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Citation Excerpt :
Positivity to CD-34 is a common feature of intracranial and spinal HPCs and has also been described in disseminated disease. However, it does not play a pivotal role in HPC diagnosis.11 Although there is no evidence to support the relationship between these markers and a more aggressive behavior, their presence could be considered as high-rate replication signs and possibly high chance of recurrence.
Hemangiopericytomas (HPCs) are rare vascular tumors with a high malignant potential. Hepatic metastases from HPC are very infrequent and usually show a distinctive solid aspect with a surrounding pseudocapsule.
A 37-year-old man with a previous medical history of recurrent spinal hemangiopericytoma with a 9 cm × 7 cm cystic hepatic mass detected on follow-up. Contrast enhanced US and MRI confirmed the presence the lesion showing mixed (solid and cystic) content. Parasitic and viral serology plus serum tumoral markers (CEA, ca 19.9, ca 125, AFP) tests, upper and lower endoscopy and general laboratory tests were normal and extended left lobectomy was performed. Histopathologic study confirmed the diagnosis of multifocal metastasic hemangiopericytoma with moderate CD-34, CD-99 and Bcl-2 positivity after immunohistochemical staining. After 1-year follow-up the patient does not present any evidence of abdominal recurrence but a skull base recurrence has been detected.
Liver metastasis from spinal HPC are uncommon and do not have cystic appearance so radiologic diagnosis can be challenging. In spite of the presence of previously diagnosed HPC context, the presence of a liver cystic mass in a young patient makes necessary to discard a number much more frequent benign and malignant diagnosis before metastatic disease can be confirmed.
The presence of a cystic hepatic mass makes it mandatory to rule out a number neoplasms other than metastasic HPC before a definitive diagnosis is made. In addition to local radiotherapy and antiangiogenic agents, surgery can be useful to treat liver dissemination.
Preoperative Chemotherapy to Salvage the Hand in a Case of Giant Infantile Hemangiopericytoma
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Citation Excerpt :
with no evidence of disease recurrence. First described by Stout and Murray in 1942,2 HPC consists of tightly packed spindle-shaped cells around endothelium-lined vascular channels, ranging in size from capillaries to sinusoids.14,15 Clinical presentation is a painless, gradually enlarging, soft tissue mass,16 whereas MRI shows a well-circumscribed vascular tumor with variable enhancement.14,17
Hemangiopericytoma (HPC) is a rare vascular tumor arising from contractile cells around blood vessels, with the potential for malignant degeneration. Up to 10% of HPC occurs in children. Standard therapy for this tumor is surgical excision. We report the case of a 6-month-old infant with giant HPC involving the hand. Chemotherapy resulted in a decrease in tumor size, allowing for salvage of most of the hand and fingers. Preoperative chemotherapy should be considered in the care of HPC tumors involving the upper extremity in children.
Intracavernous sinus solid-cystic haemangiopericytoma: a rare entity with radiology-pathology correlation
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Citation Excerpt :
Although the presence of enhancement does not rule out peritumoural cysts, these seem unlikely given the imaging and histological findings. Other imaging findings include presence of intratumoural haemorrhage,8 flow voids, and focal, mushroom-like configuration patterns. Chiechi et al.6 and Akiyama et al.9 reported intratumoural flow voids as frequent findings in haemangiopericytomas.
Haemangiopericytoma - Base of tongue
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Haemangiopericytoma is a rare vascular neoplasm arising from pericytes in the walls of the capillaries and venules. This tumor is reported to occur mostly in lower extremity and retro peritoneum with rare occurrence in the head and neck region. Generally they are slow growing, locally infiltrative and aggressive, with various rates of pleomorphism and malignant potential. Clinical presentations of these tumors are characteristically non-specific and diagnostic modalities are of little help. Surgery remains the gold standard of the treatment with additional benefits if adjuvant RT is taken. Here we report a case of haemangiopericytoma arising in the base of the tongue with a brief review of the literature. To our knowledge this is the first case in this location to be reported in the English literature.
Presentation of Infantile Hemangiopericytoma/Solitary Fibrous Tumor as a Giant Extracranial Temporal Mass
2021, Fetal and Pediatric Pathology

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ReviewHaemangiopericytoma: current status, diagnosis and management

Hum Pathol

Am J Obstet Gynaecol

Am J Ophthalmol

Surg Neurol

Am J Obstet Gynaecol

Ophthalmology

Clin Radiol

Am J Surg

Pathol Res Pract

J Urol

Haemangiopericytoma

A vascular tumour featuring Zimmerman's pericytes

Ann Surg

Der feinere bau der blutcapillaren

Z Anat Entwicklungsg

Tumours featuring pericytes: glomus tumours and haemangiopericytoma

Lab Invest

Haemangiopericytoma

A clinicopathologic study and long-term follow-up of 60 patients

Cancer

Haemangiopericytoma

Cancer

Haemangiopericytoma

Cancer

Haemangiopericytoma of omentum

Surgery

Haemangiopericytoma like tumour of nasal cavity

A comparison with haemangiopericytoma of the soft tissue

J Laryngoscop

Haemangiopericytoma of the orbit

A clinicopathological study of 30 cases

Hum Pathol

Haemangiopericytoma of the orbit

Arch Ophthalmol

Haemangiopericytoma of the larynx: a case report and review of literature

Otolaryngol Head Neck Surg

Haemangiopericytoma of the spleen

Surgery

Intraspinal haemangiopericytomas: report of two cases and review of literature

Spine

Massive pulmonary haemangiopericytoma: an innotative approach

Cancer

Haemangiopericytoma of the sternum

Arch Pathol Lab Med

Control of hypoglycaemia with diazoxide and hormones

Ann NY Acad Sci

Perirenal haemangiopericytoma

A case associated with hypoglycaemia

JAMA

Mesodermal tumours associated with hypoglycaemia: review of literature and report of a case

Ann Surg

Review
Haemangiopericytoma: current status, diagnosis and management