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Vahdani K, Rose GE, Verity DH. Long-Term Surgical Outcome for Orbital Solitary Fibrous Tumors. Ophthalmic Plast Reconstr Surg 2023; 39:606-613. [PMID: 37405750 DOI: 10.1097/iop.0000000000002446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
PURPOSE To report long-term outcomes after surgery for orbital solitary fibrous tumors. METHODS Retrospective review of patients with orbital solitary fibrous tumor, first seen between 1971 and 2022. Primary excisions were grouped as (A) surgically intact, (B) macroscopic, but with cell spillage, or (C) known incomplete excision. RESULTS Fifty-nine patients (31 female; 53%) presented at a mean age of 43.0 years (19-82 years), with 5 patients (8.5%) having malignant solitary fibrous tumors. Average follow up was 11.4 years (median 7.8; range 1-43 years). There were 28 of 59 (47%) group A patients with 1 of 28 (3%) having recurrence, 20 of 59 (34%) group B having 6 of 20 (30%) recurrences, and 11 of 59 (19%) group C with 9 of 11 (82%) recurrence ( p < 0.001 for recurrence rate). At a mean of 8.9 (range 1-23.6) years after initial treatment, continued local tumor growth was evident in 16 (27%) patients, with higher-grade recurrence in 3 of 14 (21%) cases. No patient had systemic disease at presentation, but 2 of 59 patients (3%) developed metastases at 22 and 30 years after first treatment. The 10-year progression-free survival was 94% (group A), 60% (group B), and 36% (group C). Tumor disruption or incomplete excision (groups B + C) carries the highest risk of tumor recurrence (hazard ratio 15.0; 95% confidence interval, 1.98-114; p = 0.009), with no correlation to tumor size or histology. CONCLUSIONS Orbital solitary fibrous tumors have a low recurrence rate with surgically intact excision; piecemeal excision, capsular disruption, or known incomplete resection have a high recurrence rate, which can occur decades later. Baseline postoperative scans is recommended, together with long-term clinical and interval imaging.
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Affiliation(s)
- Kaveh Vahdani
- Orbital Service, Moorfields Eye Hospital, London, United Kingdom
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Hemangiopericytoma: Incidence, Treatment, and Prognosis Analysis Based on SEER Database. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2468320. [PMID: 33204688 PMCID: PMC7655240 DOI: 10.1155/2020/2468320] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
Background Hemangiopericytomas are rare tumors derived from pericytes surrounding the blood vessels. The clinicopathological characteristics and prognosis of hemangiopericytoma patients remain mostly unknown. In this retrospective cohort study, we assessed the clinicopathological characteristics of hemangiopericytoma patients, as well as the clinical usefulness of different treatment modalities. Material and Methods. We collected the clinicopathological data (between 1975 and 2016) of hemangiopericytoma and hemangioendothelioma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence, treatment, and patient prognosis were assessed. Results Data from 1474 patients were analyzed in our study cohort (hemangiopericytoma: n = 1243; hemangioendothelioma: n = 231). The incidence of hemangiopericytoma in 2016 was 0.060 per 100,000 individuals. The overall survival (OS) and cancer-specific survival (CSS) did not differ between patients with hemangioendothelioma and those with hemangiopericytoma (P = 0.721, P = 0.544). The tumor grade had no effect on the OS of hemangiopericytoma patients. Multivariate analysis revealed the clinical usefulness of surgery in hemangiopericytoma patients (HR = 0.15, 95% confidence interval: 0.05-0.41, P < 0.001). In contrast, radiotherapy did not improve OS (P = 0.497) or CSS (P = 0.584), and chemotherapy worsened patient survival (P < 0.001). Additionally, the combination of surgery and radiotherapy had a similar effect with surgery alone on hemangiopericytoma patient survival (OS: P = 0.900; CSS: P = 0.156). Surgery plus chemotherapy provided a worse clinical benefit than surgery alone (P < 0.001). Conclusions Our findings suggested that hemangiopericytoma had a similar prognosis with hemangioendothelioma. Surgery was the only effective treatment that provided survival benefits in hemangiopericytoma patients, while the clinical usefulness of adjuvant chemotherapy or radiotherapy was limited.
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Esber Z, Schwarze E, Critchfield J, Soubani AO. Serial transarterial embolization for the management of unresectable malignant pulmonary hemangiopericytoma: A case report and review of the literature. Respir Med Case Rep 2019; 28:100920. [PMID: 31453082 PMCID: PMC6704372 DOI: 10.1016/j.rmcr.2019.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/26/2022] Open
Abstract
Hemangiopericytomas (HPC) are perivascular neoplasms that are rarely encountered as primary lung malignancy. Surgical resection remains the mainstay therapy of HPC. A 37-year old African American female initially presented with fatigue, chest pain and palpitations. Chest radiography showed a well-circumscribed large heterogeneous vascular mass of the right hemithorax. She underwent a CT-guided biopsy of the thoracic mass and was diagnosed with low-grade pulmonary hemangiopericytoma. High tumor vascularity burden and liver metastases precluded her from being a surgical candidate. Three years ago, she referred to our facility seeking further management. She did not tolerate systemic chemotherapy. Alternatively, she had been successfully managed with serial transarterial embolization and oral angiogenesis inhibitor to date. This therapeutic approach can be further explored for long term control of unresectable pulmonary HPC.
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Affiliation(s)
- Zahia Esber
- Wayne State University School of Medicine, Division of Pulmonary and Critical Care Medicine, USA
| | | | - Jeffery Critchfield
- Wayne State University, School of Medicine/Karmanos Cancer Center, Department of Interventional Radiology, USA
| | - Ayman O Soubani
- Wayne State University, School of Medicine Division of Pulmonary and Critical Care Medicine, USA
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Pathological Features and Clinical Course in Patients With Recurrent or Malignant Orbital Solitary Fibrous Tumor/Hemangiopericytoma. Ophthalmic Plast Reconstr Surg 2019; 35:148-154. [DOI: 10.1097/iop.0000000000001189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Ciliberti MP, D'Agostino R, Gabrieli L, Nikolaou A, Sardaro A. The radiation therapy options of intracranial hemangiopericytoma: An overview and update on a rare vascular mesenchymal tumor. Oncol Rev 2018; 12:354. [PMID: 30101003 PMCID: PMC6068394 DOI: 10.4081/oncol.2018.354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/20/2018] [Indexed: 12/05/2022] Open
Abstract
Hemangiopericytoma (HPC) is an extremely rare hypervascular tumor of mesenchymal lineage. It tends to recur and to develop distant metastases even many years after primary surgical resection. The management of recurrent and metastatic disease is not always so well defined. A complete surgical resection does not eliminate the high risk of local recurrences that occur in the central nervous system, often in the same surgical bed. However, treatment with adjuvant radiotherapy even in cases of complete resection remains controversial. Because of its rarity, there is no standard for treatment. We focused on radiotherapy treatment options, analyzing the literature and making a base on conduct further studies to establish the standard radiation dose to be used for locoregional control of such a complex and extremely rare disease and to help specialists to take the most appropriate therapeutic option.
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Affiliation(s)
- Maria Paola Ciliberti
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari, Italy
| | - Rosa D'Agostino
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari, Italy
| | - Laura Gabrieli
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari, Italy
| | - Anna Nikolaou
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari, Italy
| | - Angela Sardaro
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari, Italy
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Ratneswaren T, Hogg FRA, Gallagher MJ, Ashkan K. Surveillance for metastatic hemangiopericytoma-solitary fibrous tumors-systematic literature review on incidence, predictors and diagnosis of extra-cranial disease. J Neurooncol 2018; 138:447-467. [PMID: 29551003 DOI: 10.1007/s11060-018-2836-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/07/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Intracranial hemangiopericytomas (HPC) and solitary fibrous tumors (SFTs) (HPC-SFT) are rare vascular tumors that resemble meningioma on imaging and predominantly affect young adults. HPC-SFT have a high rate of local recurrence with well-known propensity for extracranial metastases. This provides clinical dilemmas frequently encountered in oncology: (i) How should these patients be monitored long term? (ii) Which primary tumors are more likely to metastasize? OBJECTIVES This systematic review aims to identify the incidence, common locations and time to presentation of extra-cranial metastases of HPC-SFT. We will assess the effect of primary tumor location, treatment, grade, patient age, gender and effect of local recurrence on rates of extra-cranial metastasis and discuss the ideal techniques by which patients with intracranial HPC-SFT should be monitored for extra-cranial metastases. METHODS Using PRISMA guidelines the authors searched Pubmed. Search terms included hemangiopericytoma, HPC, solitary fibrous tumor/ tumour, SFT, HPC-SFT, extra-cranial metastases, metastases, recurrence, monitoring, follow-up. Studies were identified up to 1st February 2018. Reference lists of identified articles were reviewed to detect other relevant citations. Data were extracted using a standard data collection form and results organized into (i) general study/patient characteristics, (ii) location of extra-cranial metastases, (iii) methods by which metastases were detected and followed up and (iv) characteristics of primary tumors. RESULTS Seventy-one studies were identified. Mean recorded follow up ranged from 4 to 312 months. Mean age at diagnosis was 42.0 years. The overall rate of extra-cranial metastasis was 28% (n = 251/904). The minimum time to extracranial metastases was 3 months and the maximum time was 372 months. In the 71 studies identified, where site of extra-cranial metastasis was specified, there were 347 metastases in 213 patients. The most common sites for metastases were bone (location not specified) (19.6%) followed by lung and pleura (18.4%), liver (17.6%), and vertebrae (14.1%). Extra-cranial metastatic disease is typically diagnosed following symptomatic presentation. There is little documentation of methods used to monitor patients with extra-cranial HPC-SFT and no clear surveillance paradigm observed. Higher primary tumor grade (WHO Grade III) was associated with a 1.88 (p = 0.016) increased risk of extra-cranial metastasis. Location and treatment of primary tumor, local recurrence, patient age and gender were not. CONCLUSION 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.
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Affiliation(s)
- Tarini Ratneswaren
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.
| | - Florence Rosie Avila Hogg
- Department of Neurosurgery, King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
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Cheng KP, Wong WJ, Hashim S, Mun KS. Hemangiopericytoma 11 years later: delayed recurrence of a rare soft tissue sarcoma. J Thorac Dis 2017; 9:E752-E756. [PMID: 29221336 DOI: 10.21037/jtd.2017.08.74] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hemangiopericytomas (HPCs) are uncommon tumours. We present the case of a 41-year-old female with multiple resections at different sites over the course of 11 years. The approach considerations, as well as treatment options and prognosis are discussed. A 41-year-old female with two previous resections for intracranial meningeal HPC in 2004 and 2008, as well as adjuvant radiotherapy, presented in 2015 with left intrathoracic and left hip recurrence confirmed by positron emission tomography/computed tomography (PET/CT). She underwent left proximal femur resection/reconstruction and video-assisted thoracoscopic surgery (VATS) resection of the intrathoracic tumour was attempted. She was discharged home on her 4th post-operative day with minimal pain. There were no neurosensory or motor deficits. Any patient who has been diagnosed with HPC in the past who develops new symptoms should be worked up for recurrence, regardless of the length of disease-free interval, as our case study suggested. There has yet to be a standardized follow-up regime due to the rarity of these tumours. HPC remains a rare soft tissue sarcoma with high recurrence rate. Planned VATS evaluation and resection is possible provided complete resection with clear surgical margins can be achieved, as clear surgical margins offer the best chance of survival.
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Affiliation(s)
- Keng Peng Cheng
- Cardiothoracic Surgery Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Wei-Jin Wong
- Cardiothoracic Surgery Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Shahrul Hashim
- Cardiothoracic Surgery Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Kein Seong Mun
- Department of Pathology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
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Gupta S, Gouw L, Wright J, Chawla S, Pitt D, Wade M, Boucher K, Sharma S. Phase II study of amrubicin (SM-5887), a synthetic 9-aminoanthracycline, as first line treatment in patients with metastatic or unresectable soft tissue sarcoma: durable response in myxoid liposarcoma with TLS-CHOP translocation. Invest New Drugs 2016; 34:243-52. [DOI: 10.1007/s10637-016-0333-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/16/2016] [Indexed: 01/17/2023]
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Demicco EG, Wani K, Fox PS, Bassett RL, Young ED, Lev D, Aldape KD, Lazar AJ, Wang WL. Histologic variability in solitary fibrous tumors reflects angiogenic and growth factor signaling pathway alterations. Hum Pathol 2015; 46:1015-26. [DOI: 10.1016/j.humpath.2015.03.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/23/2015] [Accepted: 03/30/2015] [Indexed: 02/06/2023]
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Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature. Case Rep Oncol Med 2015; 2015:214306. [PMID: 26090247 PMCID: PMC4450339 DOI: 10.1155/2015/214306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/07/2015] [Indexed: 01/08/2023] Open
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.
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11
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Wei G, Kang X, Liu X, Tang X, Li Q, Han J, Yin H. Intracranial meningeal hemangiopericytoma: Recurrences at the initial and distant intracranial sites and extraneural metastases to multiple organs. Mol Clin Oncol 2015; 3:770-774. [PMID: 26171177 DOI: 10.3892/mco.2015.537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 03/04/2015] [Indexed: 11/06/2022] Open
Abstract
Regardless of the controversial pathogenesis, intracranial meningeal hemangiopericytoma (M-HPC) is a rare, highly cellular and vascularized mesenchymal tumor that is characterized by a high tendency for recurrence and extraneural metastasis, despite radical excision and postoperative radiotherapy. M-HPC shares similar clinical manifestations and radiological findings with meningioma, which causes difficulty in differentiation of this entity from those prognostically favorable mimics prior to surgery. Treatment of M-HPC, particularly in metastatic settings, remains a challenge. A case is described of primary M-HPC with recurrence at the initial and distant intracranial sites and extraneural multiple-organ metastases in a 36-year-old female. The metastasis of M-HPC was extremely extensive, and to the best of our knowledge this is the first case of M-HPC with delayed metastasis to the bilateral kidneys. The data suggests that preoperative computed tomography and magnetic resonance imaging could provide certain diagnostic clues and useful information for more optimal treatment planning. The results may imply that novel drugs, such as temozolomide and bevacizumab, as a component of multimodality therapy of M-HPC may deserve further investigation.
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Affiliation(s)
- Guangquan Wei
- Department of Radiology and Molecular Imaging, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Xiaowei Kang
- Department of Radiology and Molecular Imaging, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Xianping Liu
- Department of Radiology and Molecular Imaging, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Xing Tang
- Department of Radiology and Molecular Imaging, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Qinlong Li
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Juntao Han
- Department of Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
| | - Hong Yin
- Department of Radiology and Molecular Imaging, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, P.R. China
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Lee SJ, Kim ST, Park SH, Choi YL, Park JB, Kim SJ, Lee J. Successful use of pazopanib for treatment of refractory metastatic hemangiopericytoma. Clin Sarcoma Res 2014; 4:13. [PMID: 25276340 PMCID: PMC4179434 DOI: 10.1186/2045-3329-4-13] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/18/2014] [Indexed: 11/10/2022] Open
Abstract
Hemangiopericytoma is a rare disease entity of soft-tissue sarcoma (STS) that can be cured with surgical resection. In cases of inoperable recurrence or metastasis, palliative chemotherapy is indicated, though there is currently no approved chemotherapy regimen. Therefore new treatment regimens are needed. We describe three cases of metastatic hemangiopericytoma. In the first case, five lines of chemotherapeutic agents were used unsuccessfully in a patient with a 12-year history of metastatic hemangiopericytoma. After one cycle of pazopanib therapy, however, chest radiography showed a decrease in tumor volume of more than 30%. A marked decrease in FDG uptake on PET CT was also noted, and the patient is now on her 5th month of pazopanib therapy. The second case is a patient with a brain hemangiopericytoma with multiple liver, lung, and bone metastases. Pazopanib induced radiologic stabilization of metastatic disease over the course of 8 months. The third case is a patient with a retroperitoneal hemangiopericytoma with pleural and peri-renal metastases. For more than 8 months, he has exhibited stable disease with pazopanib treatment. Pazopanib may be useful for treatment of metastatic hemangiopericytoma, though further studies are needed to confirm the efficacy of this medication and to investigate its molecular mechanism of action.
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Affiliation(s)
- Su Jin Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea
| | - Seung Tae Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea
| | - Yoon La Choi
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Joo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeeyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea
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Fabbri A, Grifoni E, Ciuti G, Fedi R, Moggi Pignone A. Central nervous system hemangiopericytoma with bone and lung metastases: a case report. Intern Emerg Med 2014; 9:349-50. [PMID: 23820964 DOI: 10.1007/s11739-013-0975-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/24/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Alessia Fabbri
- SOD Medicina Interna ad Orientamento all'Alta Complessità Assistenziale 3, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy,
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Akiyama T, Yoshida K, Horiguchi T, Kawase T. Management of Hemangiopericytoma. TUMORS OF THE CENTRAL NERVOUS SYSTEM 2014. [DOI: 10.1007/978-94-007-7602-9_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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15
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Balibrea JM, Rovira-Argelagués M, Otero-Piñeiro AM, Julián JF, Carrato C, Navinés J, Sánchez MC, Fernández-Llamazares J. Multifocal hepatic cystic mass as first manifestation of metastatic spinal hemangiopericytoma. Int J Surg Case Rep 2012; 4:15-8. [PMID: 23103627 DOI: 10.1016/j.ijscr.2012.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 08/31/2012] [Accepted: 09/11/2012] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Hemangiopericytomas (HPCs) are rare vascular tumors with a high malignant potential. Hepatic metastases from HPC are very infrequent and usually show a distinctive solid aspect with a surrounding pseudocapsule. PRESENTATION OF CASE A 37-year-old man with a previous medical history of recurrent spinal hemangiopericytoma with a 9cm×7cm cystic hepatic mass detected on follow-up. Contrast enhanced US and MRI confirmed the presence the lesion showing mixed (solid and cystic) content. Parasitic and viral serology plus serum tumoral markers (CEA, ca 19.9, ca 125, AFP) tests, upper and lower endoscopy and general laboratory tests were normal and extended left lobectomy was performed. Histopathologic study confirmed the diagnosis of multifocal metastasic hemangiopericytoma with moderate CD-34, CD-99 and Bcl-2 positivity after immunohistochemical staining. After 1-year follow-up the patient does not present any evidence of abdominal recurrence but a skull base recurrence has been detected. DISCUSSION Liver metastasis from spinal HPC are uncommon and do not have cystic appearance so radiologic diagnosis can be challenging. In spite of the presence of previously diagnosed HPC context, the presence of a liver cystic mass in a young patient makes necessary to discard a number much more frequent benign and malignant diagnosis before metastatic disease can be confirmed. CONCLUSION The presence of a cystic hepatic mass makes it mandatory to rule out a number neoplasms other than metastasic HPC before a definitive diagnosis is made. In addition to local radiotherapy and antiangiogenic agents, surgery can be useful to treat liver dissemination.
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Affiliation(s)
- José M Balibrea
- Department of General and Digestive Surgery, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona (Barcelona), Spain.
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