Hemangiopericytoma in the lateral ventricle

Intraventricular Hemangiopericytoma: A Case Report and Literature Review

BACKGROUND

Hemangiopericytomas are rare intracranial neoplasms that generally occur in the fifth decade of life and are commonly dural-based, supratentorial tumors. They are classified as World Health Organization grade II or III because of their aggressive nature with high rates of local recurrence and distant metastasis. This case is of an intraventricular hemangiopericytoma in a 23-year-old man. Intraventricular locations are rare, with only 10 cases reported in the literature. Our patient is the youngest to be diagnosed with an intraventricular hemangiopericytoma outside a pediatric case discovered at autopsy.

CLINICAL PRESENTATION

A 23-year-old man with a left intraventricular hemangiopericytoma presenting with headache, word-finding difficulties, blurred vision, nausea, vomiting, photophobia, and right-sided weakness and numbness. Using a left superior parietal lobule approach, a piecemeal resection was completed, achieving radiographic gross total resection. Pathology was consistent with a hemangiopericytoma. He was treated adjunctively with 60 Gy of local radiation. At 6-month follow-up, the patient had resolution of his aphasia and improvement in his headaches, with no signs of recurrence or metastasis on imaging.

CONCLUSIONS

Standard treatment for central nervous system hemangiopericytoma includes aggressive surgical resection. The role of adjuvant radiation is less well defined but is commonly pursued postoperatively. Regardless of extent of resection or adjuvant treatment, close follow-up to evaluate for evidence of local recurrence and distant metastasis is essential.

Anaplastic hemangiopericytoma in the frontal horn of the lateral ventricle

Intracranial hemangiopericytomas are uncommon tumors, and their intraventricular occurrence is even rarer. We report a 40-year-old man who presented with raised intracranial pressure. His MRI showed a 3.3 × 3.2 × 3.2 cm heterogeneously enhancing lesion in the left frontal horn obstructing the foramen of Monro and causing hydrocephalus. The tumor was excised through an anterior interhemispheric, transcallosal approach, and histopathology revealed an anaplastic hemangiopericytoma (World Health Organization grade III). To our knowledge this is the first report of this rare pathology being located within the frontal horn of the lateral ventricle.

Pancreatic metastases of cerebellar hemangiopericytoma occurring 24 years after initial presentation: report of a case

Hemangiopericytoma (HPC) preferentially developing in soft tissues and the meninges has been gradually recognized to be an aggressive, highly metastatic tumor. We herein report the case of a 65-year-old male with pancreatic metastases of cerebellar HPC that developed following two resections of intracranial local recurrent foci, 24 years after the initial craniotomy and 7 years after resection of metastases to the lungs and kidneys. Follow-up abdominal computed tomography scanning and magnetic resonance imaging revealed a solitary tumor in the pancreatic body. Since no other recurrent foci were detectable, distal pancreatectomy was performed. Another metastasis was incidentally found in the resected pancreas. Both foci were pathologically proven to be metastases of HPC. Among the 12 reported cases of pancreatic metastases of HPC, including ours, this case showed the longest duration between initial onset and the development of pancreatic metastases, suggesting that providing long-term follow-up is necessary for HPC patients.

"Hitting all the right markers to save a life" Solitary fibrous tumors of the central nervous system: Case series and review of the literature

Background:

Solitary fibrous tumors (SFTs) of the central nervous system are uncommon. Their biological features remain largely unknown; hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data. For this reason, we present two cases of large SFTs to illustrate a comprehensive review.

Methods:

This was a retrospective analysis of two patients: a 65-year-old male with a left parietooccipital lesion and a 70-year-old female with a right parietal convexity mass.

Results:

Gross total resection was performed in the male patient with no recurrence 30 months after resection. The second patient received stereotactic radiosurgery for what was initially thought to be a parafalcine meningioma; however, continued growth 1 year later prompted an open resection, with pathology indicative of an SFT. The tumor recurred the following year requiring repeat resection. Unfortunately, due to the aggressive nature of the lesion, the patient eventually succumbed to tumor burden a year later.

Conclusion:

Based on the literature review, the sometimes observed aggressive growth pattern, and also, the potential for malignant transformation, we recommend complete resection of SFTs with close sequential follow-up.

Hemangiopericytoma in the trigone of the lateral ventricle

A 67-year-old right-handed woman presented with a case of hemangiopericytoma in the lateral ventricle manifesting as digit number memory disturbance, sensory aphasia, and right quadrantanopsia. Magnetic resonance imaging demonstrated a 6-cm homogeneously enhanced mass in the trigone of the left lateral ventricle. The tumor was totally removed via the left inferior temporal gyrus. The histological findings were consistent with hemangiopericytoma. Differential diagnosis of hemangiopericytoma from meningioma and solitary fibrous tumors is very important because the clinical behavior of hemangiopericytoma is very aggressive, including local recurrence or distant metastases in the central nervous system and periphery. Histological confirmation is required to make a definitive diagnosis. The present patient did not receive radiation therapy, but developed no local recurrence or metastases. Complete surgical resection and awareness of hemangiopericytoma in the lateral ventricle are very important for good clinical outcome.