Management of intracranial meningeal hemangiopericytomas: outcome and experience

Abstract

Hemangiopericytomas represent rare intracranial tumors that have a tendency to recur locally and have the unique characteristic of giving extracranial metastases. Our current communication reviews a series of patients diagnosed with hemangiopericytoma who were treated in our facility. Eleven patients with a mean age of 51.2 years underwent follow-up for a mean time of 7.1 years. Their neuroimaging preoperative evaluation included plain skull X-rays, head CT scans, brain MRI, angiograms, and (1)HMRS. Preoperative embolization of the tumor was employed in 6/11 patients. All patients underwent craniotomy for tumor resection and postoperative radiation treatment was employed on all but one. Grade I resection was accomplished in 6/11 (54.5%), grade III in 4/11 (36.4%), and grade IV in 1/11 (9.1%). Local recurrence was detected in 3/11 (27.3%) at a mean period of 5 (range 2-7.5) years. Extracranial metastatic disease was documented in 4/11 (36.4%) patients at a mean of 4.9 (range 2.5-7) years after the initial diagnosis. The GOS score was: 7/11 (63.6%) scored 5, while 4/11 (36.4%) died at a mean time of 5.5 (range 3-8) years after the initial diagnosis. Intracranial hemangiopericytomas management requires aggressive surgical resection, postoperative radiation treatment, and extensive follow-up to rule out local recurrences and delayed extracranial metastases.

Intracranial Meningeal Hemangiopericytomas in Children and Adolescents: CT and MR Imaging Findings

“…It has been recommended that preoperative embolization be performed. 7 Large quantities of blood should be prepared for transfusion during surgery. Tumors in our study were irregularly multilobular extra-axial hypervascular tumors.…”

“…3 It has been recommended that treatment consist of aggressive surgical resection followed by high-dose (50 Gy) external radiation therapy and long-term follow-up, because hemangiopericytoma is an aggressive tumor with a malignant potential and tends to recur and occasionally metastasizes, mainly to bone, lung, and liver. 7 It is notable that the average blood loss among patients with preoperative embolization is much less than among those not receiving any embolization. 7 Intracranial hemangiopericytomas are multilobulated extra-axial hypervascular tumors and are sometimes associated with narrow-based dural attachment and bone erosion, though hyperostosis is not present.…”

“…7 It is notable that the average blood loss among patients with preoperative embolization is much less than among those not receiving any embolization. 7 Intracranial hemangiopericytomas are multilobulated extra-axial hypervascular tumors and are sometimes associated with narrow-based dural attachment and bone erosion, though hyperostosis is not present. Unlike with meningiomas, hemangiopericytomas show heterogeneous hyperattenuation on unenhanced CT scans, heterogeneous isointensity on T1WI and T2WI and show heterogeneous enhancement on both contrast-enhanced CT scans and MR images.…”

Ekstraaksiyel Beyin Tumorleri

“…BT'de hiperdenstirler. Menenjiomdan farklı olarak içerisinde kalsifikasyon veya komşu kemikte hiperostozis izlenmez [130][131][132]. Hemanjioperistomda osteolizis izlenebilir ki bu bulgu kemiğin yeniden yapılanmasına sekonder menenjiomda da izlenir [133].…”

Emergency Extracranial-Intracranial Bypass during Surgery for Anterior Clinoid Process Hemangiopericytoma with ICA Invasion—Case Report

“…Hemangiopericytoma (HPC) is a rare tumor accounting less than 1% of all intracranial tumors [1]. It originates from capillary pericyte (Zimmerman's pericyte) [2,3].…”