Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature

Abstract

Hemangiopericytoma is a rare primary tumor originating from Zimmerman's pericytes, with significant metastatic potential. Hepatic metastatic disease requires an aggressive approach by a multidisciplinary team of dedicated oncology specialists, to prolong survival in selected patients. We report on a patient with recurrent hepatic metastases of grade II intracranial hemangiopericytoma 5 years after initial treatment, managed by a stepwise combination of liver resection, radiofrequency ablation, and transarterial embolization. Although metastatic disease implies hematogenous dissemination, long-term survival after liver resection has been reported and major hepatectomies are justified in patients with adequate local control. Liver resections combined with transarterial embolization are highly recommended, due to hypervascularity of the tumor.

Multidisciplinary Treatment of Liver Metastases from Intracranial SFTs/HPCs: A Report of Three Consecutive Cases

“…In two of our reported cases (#2 and #3), surgical resection was necessary to achieve local tumor control. Reports of metastasectomies date back to the early 1960s [ 45 ], and surgical resection remains an important cornerstone in the management of liver metastases to this day ( Table 5 ) [ 18 , 60 , 63 , 66 ].…”

“…Transcatheter arterial embolization (TAE) was first reported as a treatment option in 1996 [ 31 ]. Since then, both TACE and TAE have been successfully applied in multiple cases ( Table 5 ) [ 38 , 58 , 63 , 64 ]. Radiofrequency ablation (RFA) is another promising loco-regional treatment modality that has been used to treat liver metastases in the context of SFTs/HPCs [ 58 , 60 , 63 , 66 ].…”

Multidisciplinary Management of Metastatic Hemangiopericytoma Presenting with Hypoglycemia

“…As hepatic metastases are extremely rare sequelae of this disease there is no defined consensus regarding their management. For resectable lesions excision is the preferred strategy [22]. The utility of hepatectomy, however, is dependent on the extent and geography of metastases as well as the patient's performance status and adequacy of the anticipated future liver remnant.…”

Extensive systemic metastases from primary central nervous system haemangiopericytoma

“…10 Note should be made that immunohistochemistry markers vary amongst different subgroups of HPCs, and no marker is 100% sensitive and specific. 11 …”