Surveillance for metastatic hemangiopericytoma-solitary fibrous tumors-systematic literature review on incidence, predictors and diagnosis of extra-cranial disease

Abstract

Patients with intracranial HPC-SFT require periodic, long term monitoring for extra-cranial metastases. Metastases occur in any age group and can occur early and late. They vary in location and are typically diagnosed following symptomatic presentation. There is no suggested imaging modality for surveillance. Higher grade primary tumors have a greater risk of metastasis. Regular clinical review is essential with early imaging for symptoms of recurrence/metastasis with imaging modality dependent on clinical concern. Quality evidence for an imaging surveillance protocol in this heterogeneous group of patients is lacking. A multicenter study on appropriate surveillance may be of benefit.

Extensive systemic metastases from primary central nervous system haemangiopericytoma

“…Patient demographics and intracranial tumor location also have no statistical bearing on the development of extracranial HPC metastases. 23 …”

“…Other authors have advocated lower radiation approaches to selected body regions (6–12 month interval chest X rays to evaluate for lung metastases). 23 Ratneswaren et al performed a meta-analysis of 904 HPC cases documented over 71 studies, and ultimately recommended periodic, life-long clinical surveillance with need for early imaging in patients with symptoms of recurrent disease/metastasis; the choice of imaging modality (X-ray, CT, or MRI) would be dependent on the body region of clinical concern. This recommendation is based on the knowledge that most reported HPC metastases were initially clinically symptomatic before subsequent imaging was performed to confirm metastases.…”

“…This recommendation is based on the knowledge that most reported HPC metastases were initially clinically symptomatic before subsequent imaging was performed to confirm metastases. 23 …”

Intracranial anaplastic hemangiopericytoma presenting with simultaneous extra-cranial metastases: A case report and review of the literature

“…Intracranial SFT/HPCs metastasize to extracranial locations at a rate of 11.6 to 69% within 10 years of initial diagnosis, most commonly to the lung/pleura, liver, and bone. [34] In the published literature, the reported time frame from diagnosis of the primary tumor to the diagnosis of extracranial metastases is wide and ranges from 3 to 372 months. [34] High-grade SFT/HPCs (WHO Grade III) are significantly more likely to develop extracranial metastases than low-grade tumors.…”

“…[34] In the published literature, the reported time frame from diagnosis of the primary tumor to the diagnosis of extracranial metastases is wide and ranges from 3 to 372 months. [34] High-grade SFT/HPCs (WHO Grade III) are significantly more likely to develop extracranial metastases than low-grade tumors. [34] The typical clinical course consists of the initial identification of a solitary intracranial lesion, followed by the discovery of extracranial metastases during a long-term surveillance period.…”