hemangiopericytoma occurred on the posterior tracheal wall in a 46-year-old man. A review of the pathologic findings showed that compressed groups of capillaries were lined by an intact reticulin sheath that was surrounded by spindleshaped pericytes. The ultramicroscopic findings of small spindle cells with a surrounding basal lamina and intracellular microfilaments in the absence of neurosecretory granules are important diagnostic features. Emphasis is placed on the impossibility of differentiating benign and malignant lesions pathologically, the need for long-term clinical follow-up, and the necessity for adequate complete surgical resection of these lesions. The use of a surgical approach to the posterior side of the tracheal wall can prevent postoperative stenosis. (Arch Otolaryngol 1981;107:558-560) Hemangi operi cytoma of the head and neck is a rare neoplasm that accounts for approximately 1% of all vascular neoplasms in this region. Anatomically, hemangiopericytomas are widely distributed, with about a third occurring in the head and neck region. The nasal cavity and ethmoid sinuses are the most common locations for hemangiopericytomas, followed by occasional reports of tumors that Reprint requests to the Section of Facial Plastic and Otolaryngology Surgery, The Mason Clinic, Seattle, WA 98111 (Dr Yarington). occur in the tongue, larynx, nasophar¬ ynx, maxilla, buccal sulcus, parotid region, and infratemporal fossa. To our knowledge, there has been only one previous case report of a heman¬ giopericytoma occurring in the tra¬ chea by Bremond and Garcia1; there¬ fore, the present report represents the second case of such a tumor occurring along the posterior side of the trachéal wall at the second trachéal ring.
REVIEW OF LITERATUREIn 1873, Rouget-described a special cell in the pericapillary space that he termed "cellules adventices," which subsequently became known as "Rou¬ get cells." In 1923, Zimmermann' re¬ named these cells "pericytes." In 1942, Murray and Stout1 showed, by tissue culture techniques, that these cells were identical to the epithelioid cells of the glomus tumor. In their review of vascular tumors, Murray and Stout1 reported nine cases that were appar¬ ently derived from pericytes but could not be classified as glomus tumors or the other classes of vascular tumors; these tumors were named "hemangio¬ pericytomas."5
REPORT OF A CASEA 46-year-old man had a three-month history of a sore throat, especially when he coughed and swallowed. The examination done by the patient's referring physician included a roentgenogram of the lateral soft-tissue in the neck region (Fig 1), which showed a mass that arose from the posteri¬ or side of the trachea! wall at the level of the second trachéal ring. Bronchoscopy and biopsies were done by the referring physi¬ cian on Dec 15, 1975; the result of these studies was reported as "acute and chronic inflammation." Subsequently, these pa¬ thology slides were reviewed and consid¬ ered to be nondiagnostic.The patient was then referred to The Mason Clinic, Seatt...