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Debahuti M, Anasuya L, Chandra DR, Prateek D. Infantile (congenital) anaplastic intracranial solitary fibrous tumor/hemangiopericytoma-A case report with brief literature review. INDIAN J PATHOL MICR 2023; 66:597-600. [PMID: 37530348 DOI: 10.4103/ijpm.ijpm_643_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare primary central nervous system (CNS) tumor, included in the World Health Organization (WHO) 2016 classification. Very few cases have been described in the literature so far, especially the infantile type. It is a mesenchymal tumor of the fibroblastic type, characterized by the fusion of NAB 2 and STAT 6 genes. A 10-month-old boy presented to our neurosurgery department with complaints of increasing head circumference since 1 month of age. The magnetic resonance imaging (MRI) showed a space-occupying lesion measuring 8.2 cm × 7 cm × 6.9 cm in the fronto-temporo-parietal region with a clinical diagnosis of glioma/atypical teratoid rhabdoid tumor (ATRT). The microscopy revealed a spindle cell tumor arranged in a patternless pattern with variable cellularity, increased mitosis, and areas of coagulative necrosis. The immunohistochemistry showed vimentin, CD 34, STAT6, CD99 positivity whereas Glial fibrillary acidic protein, Epithelial membrane antigen, and S-100 negativity. Hence, a diagnosis of anaplastic SFT/HPC (grade-III) was rendered. The patient improved after gross total resection (GTR). The primary intracranial congenital SFT/HPC are extremely rare, often a clinico-radiologically misdiagnosed entity. Thus, the immunohistochemistry/molecular study in addition to histology is mandatory for accurate diagnosis.
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Affiliation(s)
- Mohapatra Debahuti
- Department of Pathology, Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India
| | - Lenka Anasuya
- Department of Pathology, Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India
| | - Deo R Chandra
- Department of Neurosurgery, Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India
| | - Das Prateek
- Department of Pathology, Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India
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2
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Salavastru CM, Butacu AI, Fritz K, Eren S, Tiplica GS. [Benign skin neoplasms in children]. Hautarzt 2022; 73:127-137. [PMID: 35029698 DOI: 10.1007/s00105-021-04935-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
There are many different types of skin neoplasms in children and most are benign. Dermatologists should be able to differentiate between the various types of benign skin neoplasms and be able to recommend optimal treatment to concerned patients. Surgical removal of benign skin neoplasms is often the only treatment option. The aim of this paper is to provide a general overview of epidermal lesions (e.g., inflammatory linear verrucous epidermal nevus [ILVEN], nevus sebaceous), tumors of the epidermal appendages (e.g. pilomatrixoma), cutaneous neoplasms (e.g. angiofibroma), fibromatoses (e.g., knuckle pads), tumors comprised of fat, muscle, or bone tissue (e.g., osteoma cutis, subungual exostosis), epidermal cysts and pseudocysts, and pathologic fibrosis reactions after dermal injury (keloid). Scientific data are scarce and only in the last decade has it been possible to perform histopathological examinations and genetic studies together with detailed phenotyping to gain new understanding of the pathogenetic mechanisms.
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Affiliation(s)
- Carmen Maria Salavastru
- Pädiatrische Dermatologie, Dermatoonkologisches Forschungungslabor, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Bukarest, Rumänien
| | - Alexandra-Irina Butacu
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien.
| | - Klaus Fritz
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien.,Hautärzte und Laserzentrum Landau, Landau, Deutschland
| | - Seher Eren
- Hautärzte und Laserzentrum Landau, Landau, Deutschland
| | - George-Sorin Tiplica
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien
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Al-Qassab S, Lalam R, Botchu R, Bazzocchi A. Imaging of Pediatric Soft Tissue Tumors and Tumor-like Conditions. Semin Musculoskelet Radiol 2021; 25:39-56. [PMID: 34020467 DOI: 10.1055/s-0041-1723966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion. In this article, we offer a practical approach to diagnosing such lesions by discussing the most common three benign and malignant lesions in different anatomical regions stratified by age with emphasis on certain features that might aid in the diagnosis such as depth, multiplicity, calcification, or other specific imaging feature.
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Affiliation(s)
- Sinan Al-Qassab
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Radhesh Lalam
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Rajesh Botchu
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom
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Ghanchi H, Patchana T, Christian E, Li C, Calayag M. Pediatric sellar solitary fibrous tumor/ hemangiopericytoma: A rare case report and review of the literature. Surg Neurol Int 2020; 11:238. [PMID: 32874741 PMCID: PMC7451149 DOI: 10.25259/sni_234_2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/16/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is a rare tumor which originates from the walls of capillaries and has historically been thought to be able to occur anywhere in the body that blood vessels are found. It is rarely found in the sellar region. Case Description: InS this report, we present the first case of this tumor occurring in the sellar region of a pediatric patient. This 12-year-old male presented with progressive vision loss which prompted surgical resection after a sellar lesion was discovered on imaging. The initial transsphenoidal approach resulted in subtotal resection and the patient experienced reoccurrence within 3 months. He underwent an orbitozygomatic craniotomy to achieve gross total tumor resection. Conclusion: We conducted a literature review of intracranial SFT/HPC in the pediatric population and found it to be an extremely rare occurrence, with <30 cases reported. The incidence of SFT/HPC occurring in the sellar region for any age group was also found to be a rare entity. Treatment recommendations for this tumor are also scarce, based on retrospective chart reviews from the adult population. The role for adjuvant radiation has mixed results.
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Affiliation(s)
- Hammad Ghanchi
- Department of Neurosurgery, Riverside University Health System, Moreno Valley, United States
| | - Tye Patchana
- Department of Neurosurgery, Riverside University Health System, Moreno Valley, United States
| | - Eisha Christian
- Department of Neurosurgery, Kaiser Permanente, Los Angeles, United States
| | - Chao Li
- Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, United States
| | - Mark Calayag
- Department of Neurosurgery, Kaiser Permanente, Fontana, California, United States
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Giakoumettis D, Nikas I, Stefanaki K, Kattamis A, Sfakianos G, Themistocleous MS. Giant intracranial congenital hemangiopericytoma/solitary fibrous tumor: A case report and literature review. Surg Neurol Int 2019; 10:75. [PMID: 31528413 PMCID: PMC6744783 DOI: 10.25259/sni-85-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/08/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hemangiopericytoma and solitary fibrous tumor (HPC/SFT) are considered to be one category according to the WHO 2016 classification of central nervous system tumors. HPC/SFT are subdivided into infantile (congenital) and adult type. Both are extremely rare entities, with little knowledge about etiology, prognosis, and optimal therapeutic strategy. CASE DESCRIPTION A 10-day-old girl was referred to our neurosurgical department due to hypotonia, palsy of the right oculomotor nerve, and prominent frontal fontanel. Imaging studies revealed a large occupying mass in the right middle cerebral fossa and the suprasellar cisterns. Only a subtotal resection of the tumor was possible, and postoperatively, she underwent chemotherapy (CHx). After a 3-year follow-up, the girl has minimum neurologic signs and receives no medications, and she can walk when she is supported. CONCLUSION Congenital HPC/SFT is considered to have a benign behavior with a good prognosis. Treatment with gross total resection, when it is feasible, is the key to a good prognosis and low rates of recurrence. However, there is no consensus on the therapeutic strategy of a HPC/SFT, which is difficult to be completely resected. Literature lacks a therapeutic algorithm for these tumors, and thus, more clinical studies are needed to reach a consensus.
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Affiliation(s)
- Dimitrios Giakoumettis
- Department of Neurosurgery, University of Athens Medical School, “Evangelismos” General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Nikas
- Department of Imaging, National and Kapodistrian University of Athens, Athens, Greece
| | - Kalliopi Stefanaki
- Department of Pathology, Children’s Hospital “Aghia Sofia”, Athens, Greece
| | - Antonis Kattamis
- Department of First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - George Sfakianos
- Department of Neurosurgery, Children’s Hospital “Aghia Sophia”, Athens, Greece
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Solid Cancers in the Premature and the Newborn: Report of Three National Referral Centers. Pediatr Neonatol 2016; 57:295-301. [PMID: 26934827 DOI: 10.1016/j.pedneo.2015.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 05/25/2015] [Accepted: 08/06/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Advances in multidisciplinary care for pediatric cancer have resulted in significant improvement in cure rates over the last decades; however, these advances have not been uniform across all age groups. Cancer is an important cause of perinatal mortality, yet the full spectrum of malignant neoplasms in newborns is not well defined. METHODS The authors have reviewed the clinical features and outcomes of 37 newborns with congenital malignant tumors treated at three referral centers in North, Central, and South Poland between 1980 and 2014. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier methods and compared using long-rank test and Cox models. RESULTS Twenty-two patients were diagnosed prenatally. The most common diagnoses were neuroblastoma (48.7%), followed by malignant germ-cell tumor (16.2%), and Wilms' tumor (8.1%). Neuroblastoma was the most common malignancy among full-term infants, and malignant sacrococcygeal teratoma was the most common malignancy in premature infants. Thirty patients (81%) are alive with a median follow-up of 4.8 years from diagnosis. Patients with Wilms' tumor and malignant germ-cell tumors had the best outcomes (5-year OS 100% for both), whereas the worst prognosis was observed for sarcoma patients (5-year OS 72.92%). Premature infants had better outcome than full-term infants (5-year OS 92.8% vs. 72.58%, respectively). CONCLUSION Although rare, neonatal cancers can present with an aggressive clinical behavior, but they have a generally good outcome. Early diagnosis and management by expert multidisciplinary teams that integrate perinatal medicine experts with pediatric and surgical oncologists are critical. Centralized care with clear referral pathways that facilitate early initiation of specialized treatment should be prioritized.
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Infantile haemangiopericytoma: a rare congenital cervical tumour. The Journal of Laryngology & Otology 2014; 128:212-5. [DOI: 10.1017/s0022215113003630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Infantile haemangiopericytoma is a rare childhood vascular tumour of borderline malignancy and unpredictable clinical course. It can present a diagnostic challenge due to indeterminate clinical, radiological and pathological features. This report presents the case of a large congenital haemangiopericytoma of the neck in a neonate, and discusses diagnosis, imaging, pathology and surgical management.Clinical presentation:A full-term neonate presented with a large posterior neck mass at birth. Pre-operative radiological appearances were suggestive of teratoma, but following surgical excision the diagnosis of infantile haemangiopericytoma was confirmed on histological analysis. There were no signs of recurrence at 12-month follow up.Conclusion:Haemangiopericytoma can follow an aggressive course in adults, including local recurrence and metastasis. The infantile variant is rare but typically follows a distinct clinical course, and is associated with more benign behaviour compared with similar tumours in adults and children over one year. Congenital haemangiopericytoma can be effectively treated with surgery, without requiring adjuvant therapy.
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8
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Paulino AC. Treatment options for children with nonrhabdomyosarcoma soft tissue sarcoma. Expert Rev Anticancer Ther 2014; 4:247-56. [PMID: 15056055 DOI: 10.1586/14737140.4.2.247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nonrhabdomyosarcoma soft tissue sarcomas account for approximately 40% of all soft tissue sarcomas in children. Although these tumors are typically grouped together, individual tumor types with different biological characteristics have been found that may impact on the optimal therapy for each type of sarcoma in the future. Most of the current information regarding this tumor comes from the adult literature. Wide local excision appears to provide the best chance of cure. Future studies are needed to determine which adjuvant therapies are most useful in improving local control and overall survival in the different subsets of patients.
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Affiliation(s)
- Arnold C Paulino
- Department of Radiation Oncology, Emory Clinic, 1365 Clifton Road, NE, A1300, Atlanta, GA 30322, USA.
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9
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Erickson BP, Tse DT. Management of neonatal proptosis: a systematic review. Surv Ophthalmol 2013; 59:378-92. [PMID: 24929905 DOI: 10.1016/j.survophthal.2013.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/04/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
Gross proptosis presenting at birth is an uncommon manifestation of a variety of lesions that can compromise vision and result in disfigurement or even loss of life. Notably, many disease entities have different presentations and prognoses in neonates compared to older children. A structured mental framework is essential to an efficient and coordinated response. We present three challenging cases of neonatal proptosis and discuss the clinical presentation and biological behavior of the lesions that are most often implicated.
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Affiliation(s)
| | - David T Tse
- Bascom Palmer Eye Institute, Miami, Florida, United States.
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10
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Abstract
Haemangiopericytoma (HPC) is a rare soft tissue tumour of fibroblastic origin and is part of the solitary fibrous tumour spectrum. The tumour is generally considered to be benign, but can behave clinically as if sarcomatous -- with relentless infiltrative local growth. HPC generally presents in adulthood (median age 45 years for orbital disease) and is equally frequent in both sexes. HPC can arise in any site in the body and presents as a slowly growing, painless mass. We report a case of a 20 year old African male seen at Kikuyu Eye Unit, Kenya, with a 12 year history of a gradually enlarging, painless orbital mass. The patient underwent skin-sparing orbital exenteration with complete tumour excision; histology confirmed diagnosis of HPC.
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Affiliation(s)
- Anna M Rose
- Department of Genetics, UCL Institute of Ophthalmology, London , EC1V 9EL , United Kingdom
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11
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Yang W, Lai JY, Cheng CH, Hsueh C. Splenic hemangiopericytoma in a one-month-old infant. J Pediatr Surg 2013; 48:e21-4. [PMID: 23480943 DOI: 10.1016/j.jpedsurg.2012.12.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/26/2012] [Accepted: 12/27/2012] [Indexed: 11/30/2022]
Abstract
Hemangiopericytoma is an uncommon tumor that occurs mostly in middle-aged adults. There have been only sporadic case reports of splenic involvement, and in all but one the treatment has been total splenectomy. We present a one-month-old boy with splenic hemangiopericytoma treated with partial splenectomy. This is the youngest case in the literature, and there has been no recurrence noted after two years of follow up.
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Affiliation(s)
- Wendy Yang
- Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University, College of Medicine, Linkou, Taoyuan County 333, Taiwan (ROC)
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12
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Abstract
A 12-year-old girl had a 6-year history of a large soft-tissue mass in her left orbit. The tumor biopsy was previously performed elsewhere when she was 7 years old, but no treatment was offered at that time. Later, the tumor was completely excised, and histologic examination revealed a mesenchymal neoplasia with typical hemangiopericytoma features. At 9 months of follow up, no evidence of local recurrence or metastasis was seen.
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13
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Neonatal intracranial hemangiopericytoma: a 7-year follow-up. Acta Neurochir (Wien) 2012; 154:637-8. [PMID: 22252689 DOI: 10.1007/s00701-011-1272-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 12/29/2011] [Indexed: 10/14/2022]
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Abstract
After a brief discussion of the rarity of soft tissue sarcomas in children and of the limited ability of magnetic resonance imaging to provide a tissue diagnosis, this article discusses the incidence, presentation, treatment, prognosis, and imaging characteristics of the more common and unusual pediatric soft tissue sarcomas. It begins with extensive discussion of rhabdomyosarcoma, synovial sarcoma, and congenital/infantile fibrosarcoma. It then presents a more abbreviated discussion of uncommon tumors such as alveolar soft part sarcoma, epithelioid sarcoma, extraosseous Ewing's sarcoma, granulocytic sarcoma, hemangiopericytoma, liposarcoma, malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, and undifferentiated sarcoma.
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Affiliation(s)
- Rebecca Stein-Wexler
- Department of Radiology, University of California at Davis, Sacramento, CA 95817, USA.
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15
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Abstract
BACKGROUND Hemangiopericytoma (HPC) is a heterogeneous, highly vascularized malignant soft-tissue neoplasm with 2 different clinical presentations: adult-type and infantile-type HPC. Intracranial HPC represents a special subtype with a high proclivity toward recurrence and metastasis. METHODS The authors have reviewed the clinical features, response to treatment, and outcomes of 17 patients with HPC treated at St Jude Children's Research Hospital from 1962 to 2009. RESULTS At diagnosis, 11 patients were older than 1 year (subgroup A) and 6 patients were younger than 1 year (subgroup B). Subgroup A: median age at diagnosis 13.5 years, (range, 4 to 20 y). Primary sites were intracranial (n=5), thigh (n=3), calf (n=1), foot (n=1), and scalp (n=1). One patient who presented with a thigh HPC had metastatic disease at diagnosis, and 3 patients with head location had unresectable tumors. Two patients with thigh location experienced objective responses to chemotherapy. Six patients died of disease progression, 4 of them had an intracranial location. The remaining 5 children are alive at follow-up of 12 to 32 years. Subgroup B: median age at diagnosis 0.5 months (range, 0 to 3 mo). Primary sites were thigh (n=2), calf (n=1), perianal (n=1), forearm (n=1), and lung (n=1). Three patients with limb location had unresectable disease at diagnosis, 2 of them experienced excellent responses to neoadjuvant chemotherapy and 1 did not show any response to chemotherapy and a staged resection was performed. All 6 infants are alive without evidence of disease at follow-up of 2 to 27 years. CONCLUSIONS Infantile HPC is characterized by a better clinical behavior than the adult type, which requires an aggressive multimodality therapy. Chemoresponsiveness and spontaneous regression have been reported in children younger than 1 year, suggesting that a more conservative surgical approach should be used. Intracranial HPC is considered as an aggressive tumor because of its propensity for recurrence and metastasis.
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Masterson L, Morden R. Congenital hemangiopericytoma presenting as rectal bleeding in a neonate: a case report. J Pediatr Surg 2011; 46:e17-8. [PMID: 21376181 DOI: 10.1016/j.jpedsurg.2010.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 10/21/2010] [Accepted: 10/25/2010] [Indexed: 10/18/2022]
Abstract
Hemangiopericytoma is a rare soft tissue lesion originating from capillary pericytes that can occur anywhere vascular capillaries are found. It is an uncommon tumor found typically in adults but rarely in children. We describe a previously unreported case of an intraluminal lesion in a neonate.
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Affiliation(s)
- Loren Masterson
- Department of Surgery, William Beaumont Hospital, Royal Oak, MI 48067, USA.
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Kerl K, Sträter R, Hasselblatt M, Brentrup A, Frühwald MC. Role of neoadjuvant chemotherapy in congenital intracranial haemangiopericytoma. Pediatr Blood Cancer 2011; 56:161-3. [PMID: 20860041 DOI: 10.1002/pbc.22726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Infantile haemangiopericytoma of the CNS is a rare entity. We report the first case of a congenital haemangiopericytoma successfully treated by preoperative chemotherapy. The patient presented shortly after birth with the diagnosis of a haemangiopericytoma. As neurosurgery was too risky due to size, location and age of the patient an anthracycline-based chemotherapeutic regimen was applied and resulted in a significant decrease in tumour size, making a postchemotherapy complete surgical resection possible. Chemotherapy may benefit patients with congenital haemangiopericytoma especially if the tumour cannot initially be treated by complete neurosurgical resection.
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Affiliation(s)
- Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
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Sultan I, Casanova M, Al-Jumaily U, Meazza C, Rodriguez-Galindo C, Ferrari A. Soft tissue sarcomas in the first year of life. Eur J Cancer 2010; 46:2449-56. [DOI: 10.1016/j.ejca.2010.05.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 05/03/2010] [Accepted: 05/04/2010] [Indexed: 10/19/2022]
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19
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Schneider LF, Gardner SL, Sharma S. Preoperative chemotherapy to salvage the hand in a case of giant infantile hemangiopericytoma. J Hand Surg Am 2010; 35:995-8. [PMID: 20513579 DOI: 10.1016/j.jhsa.2010.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 02/25/2010] [Accepted: 03/03/2010] [Indexed: 02/02/2023]
Abstract
Hemangiopericytoma (HPC) is a rare vascular tumor arising from contractile cells around blood vessels, with the potential for malignant degeneration. Up to 10% of HPC occurs in children. Standard therapy for this tumor is surgical excision. We report the case of a 6-month-old infant with giant HPC involving the hand. Chemotherapy resulted in a decrease in tumor size, allowing for salvage of most of the hand and fingers. Preoperative chemotherapy should be considered in the care of HPC tumors involving the upper extremity in children.
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Affiliation(s)
- Lisa F Schneider
- Institute of Reconstructive Plastic Surgery and the Division of Pediatric Oncology, New York University Langone Medical Center, New York, NY 10016, USA
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20
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Bien E, Kazanowska B, Dantonello T, Adamkiewicz-Drozynska E, Balcerska A, Madziara W, Rybczynska A, Nurzynska-Flak J, Solarz E, Kurylak A, Zalewska-Szewczyk B, Krawczyk M, Izycka-Swieszewska E, Rapala M, Koscielniak E. Factors Predicting Survival in Childhood Malignant and Intermediate Vascular Tumors. Ann Surg Oncol 2010; 17:1878-89. [DOI: 10.1245/s10434-010-0991-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Indexed: 12/27/2022]
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A newborn with infantile fibrosarcoma of foot: treatment with chemotherapy and extremity-sparing surgery. J Perinatol 2010; 30:63-5. [PMID: 20038940 DOI: 10.1038/jp.2009.92] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infantile fibrosarcoma represents less than 1% of all childhood cancers, but it is the most common soft-tissue sarcoma in those under 1 year of age. We report an infant with congenital infantile fibrosarcoma diagnosed as hemangiopericytoma. He was treated with chemotherapy and extremity-sparing surgery. Amputation was avoided.
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Horikawa-Kyo Y, Tanaka T, Tanano H, Kitayama Y, Karakawa S, Taniyama K. Mediastinal hemangiopericytoma. Pediatr Blood Cancer 2009; 53:206-7. [PMID: 19365827 DOI: 10.1002/pbc.22054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mediastinal hemangiopericytoma (HPC) was diagnosed in a 3-year-old female. The incidence of this tumor is rare in children, and few data are available to guide clinical management. The surgical resection was incomplete and she received adjuvant radiation therapy and chemotherapy. The patient is alive without adverse events 6 years after diagnosis.
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Affiliation(s)
- Youko Horikawa-Kyo
- Department of Pediatrics, National Hospital Organization Kure Medical Center, Kure City, Hiroshima, Japan
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25
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Bien E, Stachowicz-Stencel T, Godzinski J, Balcerska A, Izycka-Swieszewska E, Kazanowska B, Madziara W, Perek-Polnik M, Mankowski P, Nurzynska-Flak J, Rybczynska A, Prokurat A. Retrospective multi-institutional study on hemangiopericytoma in Polish children. Pediatr Int 2009; 51:19-24. [PMID: 19371273 DOI: 10.1111/j.1442-200x.2008.02668.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pediatric hemangiopericytoma (HPC) is an extremely rare vascular tumor with little data available on its clinical course and management. METHODS Fourteen children with HPC registered in Polish Pediatric Rare Tumors and Polish Pediatric Soft-tissue Sarcomas Studies between 1992 and 2002 are reported. RESULTS Seven patients (F/M: 5/2, age 2-10 months) had infantile HPC, four of whom had primary tumors affecting superficial tissues of the trunk and upper limbs. No child had initial nodal or organ metastases. Primary excision (PE) was performed only in three patients with superficial lesions. They received no supplemental treatment. The remaining four children responded well to chemotherapy (CHT), entering complete remission after CHT alone (n= 2) or after delayed resection (n= 2). No relapses occurred and all patients were alive 48-146 months after treatment. Seven patients (F/M: 2/5, age 3.2-16.5 years) had adult-type HPC, five of whom had tumors localized in superficial tissues of the lower limbs or head/neck. All patients presented with locally advanced disease. PE was performed in five children (complete in four); all patients were alive at follow up of 40-127 months. Three patients died of recurrence after incomplete PE despite supplemental chemo- and radiotherapy. CONCLUSIONS Complete surgical excision remains the mainstay of treatment for both HPC types. In unresectable adult-type HPC adjuvant chemo- and radiotherapy should be administered in macro- and microscopic tumor residues, but the prognosis is poor despite supplemental treatment. High chemo-responsiveness of infantile-type HPC produces a favorable outcome even in cases of unresectable, life-threatening tumors.
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Affiliation(s)
- Ewa Bien
- Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Poland.
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Abstract
Chest wall tumors in childhood are major challenges with respect to diagnostic workup and treatment. Incidence rate is less than 1 per 1,000,000 and various benign and malignant diseases are noted. From the malignant diseases, Ewing tumors and rhabdomyosarcoma tumors are most often seen. Depending on diagnosis, staging, and age, therapy has to be tailored for each patient, which should be discussed in a multidisciplinary team setting. Radical resection is in most cases the major component of treatment. Use of chemotherapy depends on the diagnosis. In soft-tissue tumors, previously considered to be chemotherapy insensitive, favorable results are currently reported. The role of radiotherapy is debated owing to its pronounced late sequelae in children, but should be added when adequate margins cannot be achieved by surgery.
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27
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Muraoka I, Ohno Y, Kamitamari A, Okada M, Moriuchi H, Kanematsu T. Congenital occurrence of solitary infantile myofibromatosis of the spleen. J Pediatr Surg 2008; 43:227-30. [PMID: 18206487 DOI: 10.1016/j.jpedsurg.2007.08.060] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 08/22/2007] [Accepted: 08/22/2007] [Indexed: 10/22/2022]
Abstract
Infantile myofibromatosis (IM) is a rare soft tissue tumor of infancy and childhood. We report the case of a newborn girl with an abdominal tumor discovered at 32 weeks of gestation by fetal ultrasound. She underwent a laparotomy for an unexplained abdominal mass 20 days after birth. The tumor originated from the spleen and was removed by splenectomy. There were no other abnormal findings on diagnostic modalities. Based on the histological examinations, the tumor was diagnosed as an IM. Although extremely rare during the neonatal period, solitary type IM should be considered as a differential diagnosis of the splenic tumor.
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Affiliation(s)
- Izumi Muraoka
- Division of Pediatric Surgery, Department of Surgery, Nagasaki University Graduate School of Medical Sciences, Nagasaki 852-8501, Japan.
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28
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Gowans LK, Bentz ML, DeSantes KB, Thompson KJ. Successful treatment of an infant with constitutional chromosomal abnormality and hemangiopericytoma with chemotherapy alone. J Pediatr Hematol Oncol 2007; 29:409-11. [PMID: 17551404 DOI: 10.1097/mph.0b013e31806210da] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hemangiopericytoma is a rare vascular tumor, of which 5% to 10% occur in the pediatric population. Although usually benign in infants, local recurrence, metastasis, and deaths have been reported. Clonal chromosomal rearrangements have been described, most involving the long arm of chromosome 12. We report a case of a 6-month-old boy with an hemangiopericytoma of the left forearm initially incorrectly diagnosed as hemangioma. He was treated successfully with chemotherapy alone using vincristine, doxorubicin, actinomycin-D, and cyclophosphamide. Although cytogenetic analysis was not performed on his biopsy, it was later discovered that a prenatal karyotype had shown 46,XY,inv(12)(q15q24.1).
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Affiliation(s)
- L Kate Gowans
- Pediatric Hematology/Oncology, Cleveland Clinic Children's Hospital, Cleveland, OH 44195, and Department of Surgery, University of Wisconsin Cytogenetic Services-WSLH, University of Wisconsin Madison, WI, USA.
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29
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Yamanishi T, Nishio J, Inoue M, Yasui M, Toribe Y, Takeuchi M, Matsuoka Hamana K, Kitano M, Miya S. A Case of Congenital Maxillary Hemangiopericytoma: A Case Report. J Oral Maxillofac Surg 2007; 65:549-52. [PMID: 17307606 DOI: 10.1016/j.joms.2006.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 01/01/2006] [Accepted: 02/22/2006] [Indexed: 11/23/2022]
Affiliation(s)
- Tadashi Yamanishi
- Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
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30
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Ferigo N, Cottalorda J, Allard D, Gentil-Perret A, Fessy M, Berger C, Stéphan JL. Successful treatment via chemotherapy and surgical resection of a femoral hemangiopericytoma with pulmonary metastasis. J Pediatr Hematol Oncol 2006; 28:237-40. [PMID: 16679922 DOI: 10.1097/01.mph.0000212903.61276.4b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hemangiopericytoma (HPC) is a soft-tissue neoplasm composed of proliferating capillary pericytes. It has variable and unpredictable malignancy and most commonly occurs in the fifth or sixth decade of life. Diagnosis is based on the histological aspect. HPC is exceedingly rare in childhood. In both adults and children, curative surgery is the most important predictor of survival. The place of chemotherapy in the treatment of HPC is not well established. We describe a case of adult-type metastatic HPC of the thigh in a 13-year-old boy. The response to neoadjuvant chemotherapy was excellent, and local control of this initially unresectable tumor was achieved without radiation therapy or mutilating surgery. The child is alive and well and has had 8 years of follow-up after treatment.
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Affiliation(s)
- N Ferigo
- Pediatric Hematology and Oncology Unit, Hôpital Nord, University of Saint Etienne, Saint Etienne 42055, France
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31
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Hsu PY, Hsu WM, Huang HY, Chen CY, Chou HC, Tsao PN, Hsieh WS. Congenital hemangiopericytoma in a neonate. J Formos Med Assoc 2006; 105:247-51. [PMID: 16520843 DOI: 10.1016/s0929-6646(09)60314-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Hemangiopericytoma is a rare malignant vascular tumor that usually occurs in adults. The occurrence of these tumors in infants, known as congenital or infantile hemangiopericytoma, is even rarer and their behavior may be more benign than the adult type. We describe a 1-day-old female neonate with congenital hemangiopericytoma, presenting with a right inguinal mass at birth. At the time of surgery, lymphangioma was suspected because of its appearance, fluid-filled multicystic content, and the high incidence of this disease in pediatric patients. Tumor excision was performed and hemangiopericytoma was diagnosed by histology. There was no tumor recurrence during 12 months of follow-up.
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Affiliation(s)
- Ping-Yi Hsu
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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32
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Hansen JK, Soerensen FB, Christensen MF. A five-week-old girl with inspiratory stridor due to infantile hemangiopericytoma. Eur Arch Otorhinolaryngol 2006; 263:524-7. [PMID: 16465552 DOI: 10.1007/s00405-005-0003-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 09/12/2005] [Indexed: 10/25/2022]
Abstract
UNLABELLED A 5-week-old girl with inspiratory stridor is presented. No immediate cause of the stridor was found, but eventually a diagnosis of infantile hemangiopericytoma located in the rhinopharynx was made. After surgery all respiratory symptoms disappeared. CONCLUSION Infantile hemangiopericytoma is a rare tumour of infancy and a very rare cause of inspiratory stridor in this age group. The mainstay of treatment is surgery. The overall prognosis is favourable but because of the unpredictable nature of the tumour, long-term follow-up is recommended.
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Affiliation(s)
- Jonas K Hansen
- Department of Paediatrics, Herning Hospital, Gl. Landelvej, 61 7400, Herning, Denmark.
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33
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Hornoy P, Sonigo P, Fallet-Bianco C, Largiliere P, Teillac D, Gomes H, Uzan M, Brunelle F. Fetal hemangiopericytoma with an associated cerebral anomaly. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 26:81-5. [PMID: 15937963 DOI: 10.1002/uog.1913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
We report the first case of infantile hemangiopericytoma explored prenatally by fetal ultrasonography and magnetic resonance imaging (MRI). It was associated with a developmental cerebral anomaly identified on MRI. The largest lesions of the multifocal hemangiopericytoma were located in the soft tissue adjacent to the left temporal bone, and smaller lesions were found in the lumbar area and in the retroperitoneum. MRI showed no connection between the tumor and the fetal brain but there was anomalous cerebral gyration in the region and the Sylvian fissure beneath the tumor was enlarged. The pregnancy was terminated because of the severe brain anomalies and postmortem examination confirmed the prenatal findings. Microscopic analysis of the tumor tissue showed branching vessels which are typical of hemangiopericytoma. The lesions in our case occurred in association with macrosomia with visceromegaly detected at autopsy, suggesting a possible role of tumor suppressor genes.
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Affiliation(s)
- P Hornoy
- Department of Pediatric Radiology, American Memorial Hospital, Reims, Paris, France.
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34
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Barrios Fontoba JE, Sanchís Solera LF, Morell Quadreny L, Llopis San Juan E, de la Cámara de Las Heras JM. [Congenital hemangiopericytoma]. An Pediatr (Barc) 2004; 61:564-5. [PMID: 15574261 DOI: 10.1016/s1695-4033(04)78447-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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35
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Athanassiadou F, Kourti M, Papageorgiou T, Zarampoukas T, Haritanti A, Danielides S, Katriou D. Hemangiopericytoma in an adolescent girl: a case report. Pediatr Hematol Oncol 2004; 21:489-93. [PMID: 15552812 DOI: 10.1080/08880010490477275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hemangiopericytoma (HPC) is a rare soft tissue tumor The few published reports account for the little information available on its clinical management. Here the authors report the successful treatment of an adolescent girl with rare HPC of the tongue. After incomplete surgical excision of the tumor she was admitted to the Hematology-Oncology Department and was treated with a 3-drug combination regimen (ifosfamide, actinomycin D, vincristine) for 8 weeks. She achieved partial remission in week 9 based on the magnetic resonance imaging (MRI)findings. Conventional radiation therapy was initiated at week 9 and continued until week 16. At week 20, according to the MRI findings, she achieved complete remission and continuation therapy was initiated. The young girl has been alive without evidence of the disease for the last 3 years of follow-up. In conclusion, the current report indicates that in cases of incomplete surgical excision of the tumor, chemotherapy and radiotherapy seem to be effective.
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Affiliation(s)
- F Athanassiadou
- 2nd Department of Pediatrics, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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36
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Mounayer C, Benndorf G, Bisdorff A, Wassef M, Enjolras O. Facial infantile hemangiopericytoma resembling an arteriovenous malformation. J Neuroradiol 2004; 31:227-30. [PMID: 15356450 DOI: 10.1016/s0150-9861(04)96997-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Malignant highly vascularized tumors such as hemangiopericytomas (HPC) may mimic a benign arteriovenous malformation (AVM) which is sometimes still referred to as "angioma". We describe the clinical and radiological findings of a facial hemangiopericytoma in comparison to an AVM in order to avoid misdiagnosis between these two pathologies since evolution and therapeutic management are completely different. Because hemangiopericytomas in children show malignant behavior requiring aggressive management, early and accurate diagnosis is of significant importance for the clinical outcome.
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Affiliation(s)
- C Mounayer
- Department of Interventional Neuroradiology, Lariboisière Hospital, Paris.
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37
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Affiliation(s)
- William H Meyer
- Hematology/Oncology Section, Department of Pediatrics, University of Oklahoma Health Sciences Center, P.O. Box 26901, Oklahoma City, OK 73190, USA
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38
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Rao BN, Rodriguez-Galindo C. Local control in childhood extremity sarcomas: salvaging limbs and sparing function. ACTA ACUST UNITED AC 2003; 41:584-7. [PMID: 14595726 DOI: 10.1002/mpo.10405] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bhaskar N Rao
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
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39
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Sepulveda W, Muhlhausen G, Flores X, Gutierrez J, Avila R. Giant hemangiopericytoma of the fetal neck: prenatal two- and three-dimensional sonographic findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2003; 22:831-835. [PMID: 12901412 DOI: 10.7863/jum.2003.22.8.831] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Waldo Sepulveda
- Fetal Medicine Center, Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile.
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40
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Chuba PJ, Hamre MR, Fontanesi J, Rector F, Bond M, Freeman C. Brachytherapy control of a hemangiopericytoma of the tongue in a child. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 41:163-5. [PMID: 12825228 DOI: 10.1002/mpo.10330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Paul J Chuba
- Department of Radiation Oncology, St. John Health System, St. John Hospital Van Elslander Cancer Center, Grosse Pointe, Michigan, USA.
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41
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Borg MF, Forstner DF, Benjamin CS. Childhood haemangiopericytoma. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 40:331-4. [PMID: 12652626 DOI: 10.1002/mpo.10191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Martin F Borg
- Department of Radiation Oncology, Royal Adelaide Hospital, South Australia, Australia.
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42
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Lackner H, Urban C, Dornbusch HJ, Schwinger W, Kerbl R, Sovinz P. Interferon alfa-2a in recurrent metastatic hemangiopericytoma. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 40:192-4. [PMID: 12518351 DOI: 10.1002/mpo.10122] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Herwig Lackner
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescence Medicine, Karl-Franzens-University, Graz, Austria
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43
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Affiliation(s)
- Alex Zvulunov
- Department of Pediatrics, Joseftal Hospital, Eilat, Israel.
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44
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Spunt SL, Hill DA, Motosue AM, Billups CA, Cain AM, Rao BN, Pratt CB, Merchant TE, Pappo AS. Clinical features and outcome of initially unresected nonmetastatic pediatric nonrhabdomyosarcoma soft tissue sarcoma. J Clin Oncol 2002; 20:3225-35. [PMID: 12149295 DOI: 10.1200/jco.2002.06.066] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To describe the clinical features, response to therapy, and outcome of pediatric patients with initially unresected nonmetastatic nonrhabdomyosarcoma soft tissue sarcoma (NRSTS). PATIENTS AND METHODS We retrospectively reviewed the presenting clinical features and tumor characteristics of all 40 pediatric patients with initially unresected nonmetastatic NRSTS who were seen at our institution between March 1962 and December 1996. A subset of 27 patients for whom complete treatment information was available was analyzed to determine whether response to therapy was associated with local disease control and event-free and overall survival. RESULTS More than 70% of the 40 patients had tumors with high-risk features (tumor size > 5 cm, high grade, invasiveness). For the 27 patients included in the outcome analysis, 5-year event-free survival and survival estimates were 33% +/- 9% and 56% +/- 10%, respectively. Ten (37%) of these patients had a complete or partial response to neoadjuvant chemotherapy and/or radiotherapy, and only two of the 10 had residual tumor after surgery. Combined chemotherapy and radiotherapy seemed more effective than either modality alone in inducing a response, but the response to neoadjuvant therapy did not predict outcome. Most treatment failures were local, and postrelapse survival was poor (19% +/- 10%). CONCLUSION Initially unresected NRSTS constitutes a unique subgroup of pediatric sarcomas that commonly present with high-risk features and respond poorly to neoadjuvant therapy. Only about one third of patients treated with multimodal therapy remain disease-free, and local control is the major limiting factor in achieving cure. More effective risk-directed treatments are needed for this unique subgroup of patients.
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Affiliation(s)
- Sheri L Spunt
- Department of Hematology-Oncology, St Jude Children's Research Hospital, University of Tennessee College of Medicine, 332 N. Lauderdale Street, Memphis, TN 38105-2794, USA.
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45
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Ferrari A, Casanova M, Bisogno G, Mattke A, Meazza C, Gronchi A, Cecchetto G, Fidani P, Kunz D, Treuner J, Carli M. Hemangiopericytoma in pediatric ages: a report from the Italian and German Soft Tissue Sarcoma Cooperative Group. Cancer 2001; 92:2692-8. [PMID: 11745205 DOI: 10.1002/1097-0142(20011115)92:10<2692::aid-cncr1623>3.0.co;2-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hemangiopericytoma (HPC) is very uncommon in childhood and comprises two different clinical entities, the adult type and the infantile type, occurring in the first year of age. We report on a series of 27 pediatric patients treated from 1978 to 1999 by the Italian and German Soft Tissue Sarcoma Cooperative Group. METHODS Seven patients had infantile HPC; complete resection was achieved in the tumors of five patients and chemotherapy was given to four patients. Twenty children had adult type HPC; nine received complete tumor resection (four patients at diagnosis and five at delayed surgery). Post-operative radiotherapy was administered to 15 patients, chemotherapy to 19. RESULTS Six of seven patients with infantile HPC were alive in first remission; one patient died of disease. Chemotherapy achieved an objective response in four of four patients. Among the adult type HPC cases, 5-year event free survival was 64% (median follow-up 125 months); 12 patients were alive in first remission, eight patients relapsed and died of disease. Seven of 10 evaluable patients showed good response to chemotherapy. Statistically significant differences in outcome were observed in relation to Intergroup Rhabdomyosarcoma Study grouping, size, local invasiveness, and gender. CONCLUSIONS Infantile HPC is a unique entity probably related to infantile myofibroblastic lesions and characterized by a high response to chemotherapy, which is required in case of unresectable, life-threatening tumors. In children over 1 year of age, HPC behaves like its adult counterpart; complete surgical resection remains the mainstay of treatment, but chemotherapy and radiotherapy seem effective and are recommended in all patients with incomplete tumor resection and/or locally invasive, large tumors.
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Affiliation(s)
- A Ferrari
- Pediatric Oncology Unit, Istituto Nazionale Tumori, Milano, Italy.
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46
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Rodriguez-Galindo C, Hill DA, Onyekwere O, Pin N, Rao BN, Hoffer FA, Kun LE, Pappo AS, Santana VM. Neonatal alveolar rhabdomyosarcoma with skin and brain metastases. Cancer 2001; 92:1613-20. [PMID: 11745240 DOI: 10.1002/1097-0142(20010915)92:6<1613::aid-cncr1487>3.0.co;2-n] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Approximately 5-10% of patients with rhabdomyosarcomas (RMS) are diagnosed during the first year of life, and their clinical characteristics have been well documented. However, because RMS rarely occurs during the neonatal period, little is known about neonatal RMS. METHODS Four patients with neonatal RMS were treated at St. Jude Children's Research Hospital between 1962 and 1999. The authors report the results of a review of these patients and of cases described in the literature. Clinical, radiologic, and pathologic features of these patients and their outcomes were evaluated. RESULTS One patient with embryonal RMS was treated successfully with a combination of systemic chemotherapy and local control measures. The other three patients had alveolar RMS. Two of them had multiple skin and subcutaneous metastatic nodules at the time of diagnosis and developed brain metastases early in their course. In one of these patients, the PAX3-FKHR fusion transcript was detected. Three other similar cases of neonatal alveolar RMS with metastases to the skin and brain have been reported in the literature. CONCLUSIONS A distinct syndrome of neonatal RMS is described. This syndrome is characterized by alveolar histology, multiple skin and subcutaneous metastases, and fatal outcome as the result of early brain metastasis.
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Affiliation(s)
- C Rodriguez-Galindo
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
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