Intracranial Infantile Hemangiopericytoma: A Distinctive and More Benign Clinical Entity

Abstract

Intracranial infantile HPC is a rare soft-tissue tumor derived from the pericytes of Zimmerman, with a more benign clinical course distinct from childhood or adult intracranial HPC. Histologically, it is similar to infantile myofibromatosis, a mesenchymal tumor that has a benign prognosis. We present a case of intracranial infantile HPC, review the literature, and discuss radiologic features encountered in HPCs. Awareness of the more benign course of infantile HPC is important for prognostication and postresection imaging recommendations.

Intracranial hemangiopericytoma in a child: a case report with MR spectroscopy findings

“…However, there are some clues, although not fully discriminative, that may help in differentiating HPCs from meningiomas. HPCs have more heterogenous texture, enhancement pattern and narrower dural tail (2,6). Calcifications usually point to meningiomas instead of HPCs, with some rare exceptions.…”

“…In the last classification of World Health Organization (WHO), HPC is included in the "extrapleural HPC and solitary fibrous tumor" subgroup which is under the group of "fibroblastic / myofibroblastic tumors" (5). Furthermore, intracranial HPC is divided into two categories: WHO grade III anaplastic Hemangiopericytoma and WHO grade II Hemangiopericytoma (2,6). HPC has two clinical types according to the age of presentation; infantile hemangiopericytoma (<1 years) and adult type hemangiopericytoma (>1 years), with the second type being more common (4, 7).…”

“…However, these MRS findings are nonspecific and can accompany any extraaxial mass. On the other hand, short and moderate TE MRs of the abovementioned pediatric case failed to depict the peak of myoinositol reported in adult HPC patients (1,6). Myoinositol is thought to be the most important non-nitrogenous osmolyte in the mammalian brain and has been identified as a glialspecific marker.…”

“…Imaging plays an important role in the differentiation of HPC from other extraaxial mass lesions and proper treatment planning. Conventional computed tomography (CT) and magnetic resonance imaging (MRI) findings of this rare tumor are well defined, with few case reports (1,6) in the literature pointing to a possible role of magnetic resonance spectroscopy (MRs) in the adult population. However, to the best of our knowledge, there is no report discussing MRS features of HPC in the pediatric age group.…”