Haemangiopericytoma of the temporal bone

Glomangiopericytoma simulating an intracavernous meningioma

Background:

Glomangiopericytoma is an uncommonly encountered tumor of the nose and paranasal sinuses, accounting for <0.5% of all sinonasal tumors. Extension of these lesions to the anterior or middle cranial fossa is rare. When this occurs, diagnosing glomangiopericytoma is extremely challenging, as it is often confused with other anterior skull base tumors.

Case Description:

We report a case of a giant glomangiopericytoma localizing into the cavernous sinus in a 48-year-old female who presented with mild left-sided ptosis for 48 months. The lesion simulated an intracavernous meningioma on preoperative imaging. An expanded endoscopic endonasal approach was used to debulk the portion of the lesion in the medial compartment of the cavernous sinus. Postoperatively, the patient's ptosis resolved completely, and no new deficits were sustained.

Conclusion:

This is the only case of glomangiopericytoma localizing solely to the cavernous sinus reported to date.

Sinonasal hemangiopericytoma: case report and literature review

Hemangiopericytoma (HPC) is a rare vascular tumor that can arise in any organ system, but occurs most frequently in skeletal muscle. We present a case of a primary sphenoid sinus HPC unusual for its spontaneous remission after biopsy. There have been approximately 55 cases of sinonasal HPC reported in the literature, representing less than 5% of all lesions. In general, HPC behaves aggressively, demonstrating greater than 50% local recurrence and 10% metastatic disease. Although extended surgical resection is traditionally considered the most effective therapy for all HPC, critical literature review does not support this method of treatment for HPC occurring in the paranasal sinuses and skull base. Long-term follow-up indicates that the majority of sinonasal HPC have a benign clinical course regardless of treatment. As a result, we do not recommend extended resection as the initial therapy for sinonasal HPC. Instead, a period of observation coupled with serial MRI or CT scans should be used to detect tumor progression. These indolent tumors should undergo extended resection only after progression has been confirmed. In addition to the case report, a synopsis of the reviewed literature and a summary of treatment recommendations are also presented.

A case of primary intracranial hemangiopericytoma with hepatic metastases: successful treatment with radiofrequency ablation and transcatheter arterial chemoembolization

Intracranial hemangiopericytoma is an uncommon soft tissue sarcoma. We report a case of a 54-year-old Japanese female with hepatic metastasis from primary intracranial hemangiopericytoma. At age 44 years the patient underwent primary resection of the intracranial tumor, followed by no adjuvant therapy. At age 53 years she underwent resection of bone metastases in her left upper arm and tenth right rib. The following year, three hepatic tumors with high vascularity were detected by ultrasonography, computed tomography scans, and magnetic resonance imaging. An ultrasound-guided liver biopsy specimen confirmed the diagnosis of hepatic metastases from the primary intracranial hemangiopericytoma. A combination therapy of transcatheter arterial chemoembolization and radiofrequency ablation was performed against the hepatic metastasis. After 5 years, there has been no local recurrence in the liver.

Haemangiopericytoma of the middle ear with benign histological features

Haemangiopericytoma is a rare vascular tumour, particularly in the head and neck region. We described the first case of haemangiopericytoma arising from the middle ear in 1995. The present case is the second example of a primary middle-ear haemangiopericytoma with benign histological features. Clinical photography, computed tomography (CT) and magnetic resonance imaging (MRI) scans and histological photographs depict the findings.

Nasal haemangiopericytoma: report of two cases with literature review

Haemangiopericytoma (HPC) is a rare vascular tumour produced by proliferation of pericytes. One hundred and thirty-three cases of HPC have been reported in the nose and the paranasal sinuses. We present two more cases. Wide surgical excision via lateral rhinotomy, midfacial degloving, or endonasal removal is the treatment of choice. Radiotherapy has been used post-operatively in cases of incomplete removal. Life-long follow-up is required to evaluate local recurrence and late metastases.

Haemangiopericytoma of the middle ear: case report and literature review

Haemangiopericytoma is an uncommon vascular tumour that rarely appears in the head and neck region. Such a tumour arising from the middle ear has not been reported since it was first described in 1942 by Stout and Murray. The present case therefore illustrates the first example of a primary middle ear haemangiopericytoma.

Hemangiopericytoma of the temporal bone presenting as a retroauricular mass

An unusual case of a hemangiopericytoma arising from the temporal bone is presented. The patient was noted to have a postauricular mass and was neurologically asymptomatic. A preoperative magnetic resonance image and an angiogram revealed the tumor to be highly vascular. Preoperative embolization facilitated the surgical removal of the tumor by rendering it avascular. Current therapy consists of radical resection of the tumor with postoperative radiation therapy. Patients must be monitored carefully for local recurrence and systemic metastasis.