Clinical Analysis of Intracranial Hemangiopericytoma

Abstract

ObjectiveIntracranial hemangiopericytomas (HPCs) are rare tumors with aggressive behavior, including local recurrence and distant metastasis. We conducted this retrospective study to evaluate the efficacy of grossly total resection and adjuvant radiotherapy (RT) for these tumors.MethodsA total of 13 patients treated for intracranial HPC from January 1995 through May 2013 were included in this retrospective study. We analyzed the clinical presentations, radiologic appearances, treatment results, and follow-up outcomes, as well as reviewed other studies.ResultsThe ages of the patients at the time of diagnosis ranged from 26 to 73 years (mean : 48 years). The majority of the patients were male (92.3%), and the majority of the tumors were located in the parasagittal and falx. The ratio of intracranial HPCs to meningiomas was 13 : 598 in same period, or 2.2%. Seven patients (53.8%) had anaplastic HPCs. Nine patients (69.2%) underwent gross total tumor resection in the first operation without mortality. Eleven patients (84.6%) underwent postoperative adjuvant RT. Follow-up period ranged from 13 to 185 months (mean : 54.3 months). The local recurrence rate was 46.2% (6/13), and there were no distant metastases. The 10-year survival rate after initial surgery was 83.9%. The initial mean Karnofsky performance scale (KPS) was 70.8 and the final mean KPS was 64.6.ConclusionGross total tumor resection upon initial surgery is very important. We believe that adjuvant RT is helpful even with maximal tumor resection. Molecular biologic analyses and chemotherapy studies are required to achieve better outcomes in recurrent intracranial HPCs.

Treatment Strategy of Intracranial Hemangiopericytoma

“…Therefore, these tumors can occur anywhere where capillaries are found [ 1 10 ]. However, in many reported cases, as well as in our experience, most of intracranial HPCs are located at parasagittal area or at tentorium which is adjoined to the dural sinus [ 2 3 5 6 7 11 12 13 14 15 16 17 ]. Therefore, unless the dural sinus is sacrificed or reconstructed, it is difficult to literally completely remove the tumor in most cases.…”

“…Recent studies insist that the extent of surgical resection and postoperative radiotherapy (RT) correlate with improved overall survival (OS) and recurrence-free survival (RFS). However, the definitions of complete resection or grossly total resection (GTR) in previous studies are equivocal [ 5 6 7 8 ]. In most reported cases, since HPC is attached to the venous sinuses or major vessels, it is actually impossible to literally completely remove the tumor.…”

Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma

“…[3] Park et al in 2013 following their series of 13 patients with CNS HPC reported a mean age of 48 years, with male predominance and majority were located at the parasagittal or falx. [4] The location of intracranial HPCs is similar to that of meningiomas. Like meningiomas and other extraaxial masses, HPCs are dural-based and show white matter "buckling" as was seen in our case.…”

Multidisciplinary Management of Metastatic Hemangiopericytoma Presenting with Hypoglycemia

“…These tumors are most commonly diagnosed in the fifth decade of life without a clear gender distribution [2,3]. They are indiscriminate in their primary site of origin with the majority of reported cases in the lower extremities, axilla, pelvis, retroperitoneum, and head and neck [2,4].…”