Infantile hemangiopericytoma: a rare cause of a soft tissue mass

Infantile haemangiopericytoma: a rare congenital cervical tumour

Objective:

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.

Preoperative chemotherapy for congenital hemangiopericytoma and a review of the literature

PURPOSE

Malignant hemangiopericytoma is an uncommon tumor in the pediatric age group. A case of congenital hemangiopericytoma is presented with a review of the literature.

PATIENTS AND METHODS

A 2-month-old boy presented at birth with an enlarging posterior neck mass. Subsequent histopathologic studies showed findings consistent with hemangiopericytoma. Imaging studies demonstrated an extensive, infiltrative, vascular lesion not readily amenable to surgical resection. A pulmonary metastatic lesion was present.

RESULTS

Combined treatment using vincristine, doxorubicin, and cyclophosphamide given preoperatively resulted in a significant decrease in size of the primary tumor, allowing for resection without complication and resolution of the metastatic lesion.

CONCLUSION

Preoperative chemotherapy may have a significant role in the management of infants with malignant hemangiopericytoma.