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Menaker SA, Ljubimov VA, Krutikova VO, Urnes C, Bannykh SI, Ross LB, Eboli P. Intracranial solitary fibrous tumor with delayed symptomatic metastasis to the lumbar spine: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22495. [PMID: 36794737 PMCID: PMC10550599 DOI: 10.3171/case22495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Intracranial solitary fibrous tumors (SFTs), formerly known as hemangiopericytomas, are rare, aggressive mesenchymal extra-axial tumors typically treated via resection, often with preoperative embolization and postoperative radiation and/or antiangiogenic therapy. Although surgery confers a significant survival benefit, local recurrence and distant metastasis are not uncommon and may occur in a delayed fashion. OBSERVATIONS The authors describe the case of a 29-year-old male who initially presented with headache, visual disturbance, and ataxia, and was found to have a large right tentorial lesion with mass effect on surrounding structures. He underwent tumor embolization and resection with gross total resection achieved and pathology consistent with World Health Organization grade 2 hemangiopericytoma. The patient recovered well, but 6 years later presented with low back pain and lower extremity radiculopathy and was found to have metastatic disease within the L4 vertebral body causing moderate central canal stenosis. This was successfully treated with tumor embolization followed by spinal decompression and posterolateral instrumented fusion. Metastasis of intracranial SFT to vertebral bone is exceedingly rare. To our knowledge this is only the 16th reported case. LESSONS Serial surveillance for metastatic disease is imperative in patients with intracranial SFTs given their propensity and unpredictable time course for distant spread.
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Affiliation(s)
| | | | | | - Cole Urnes
- Keck School of Medicine, University of Southern California Los Angeles, Los Angeles, California
| | - Serguei I. Bannykh
- Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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Perumalsamy NK, Hemalatha C. Cis-regulatory elements (CREs) in spinal solitary fibrous tumours. Meta Gene 2022. [DOI: 10.1016/j.mgene.2022.101025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Wang L, Yu J, Shu D, Huang B, Wang Y, Zhang L. Primary endodermal hemangiopericytoma/solitary fibrous tumor of the cervical spine: a case report and literature review. BMC Surg 2021; 21:405. [PMID: 34837986 PMCID: PMC8626743 DOI: 10.1186/s12893-021-01399-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 11/07/2021] [Indexed: 12/18/2022] Open
Abstract
Background Hemangiopericytoma (HPC), also known as solitary fibrous tumor (SFT), is a type of soft tissue sarcoma with a special aggressive behavior. The HPC/SFT is locally aggressive with possibility of late recurrence locally or distant extraneural metastasis. The most common location of this HPC/SFT is the lower extremities. The HPC/SFT in the central nervous system (CNS) is very rare, and compared with the brain, it is rarer in the spinal region. However, clinicians also lack an overall understanding of the diagnosis of HPC/SFT in the spinal cord. Case presentation In this study, we report a rare case of primary cervical spine HPC/SFT in a 53-year-old woman. Two to three weeks before admission, she experienced pain and numbness in her left upper extremity. After computerized tomography (CT) and magnetic resonance imaging (MRI), a gross total resection was performed. Obvious neurological improvement was observed postoperatively. The pain and numbness in the patient's left upper limb were relieved subsequently. We then reviewed the literature on HPC/SFT, such as its clinical presentation, imaging characteristics, treatment, and follow-up. Conclusions Diagnosis of HPC/SFT relies on magnetic resonance spectroscopy, enhanced CT, and MRI. Postoperative radiotherapy is strongly recommended to reduce the HPC/SFT recurrence. Immunohistochemical analysis can also help in the differential diagnosis. However; early and long-term follow-up is necessary for patients.
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Affiliation(s)
- Liyun Wang
- Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Jianbo Yu
- Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dongping Shu
- Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Bin Huang
- Department of Neurosurgery, Xinchang Hospital of Traditional Chinese Medicine, Shaoxing, China
| | - Yumin Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
| | - Luyuan Zhang
- Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Sirko A, Malysheva T, Halkin M, Romanukha D, Pylypenko H. Successful treatment of spinal column metastatic intracranial haemangiopericytoma: A case report. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2020.100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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5
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Abstract
The management of patients harboring central nervous system (CNS) hemangiopericytomas (HPCs) is a partially answered challenge. These are rare locally aggressive lesions, with potential for local recurrence, distal neural metastasis (DNM), and extraneural metastasis (ENM). Resection, when feasible, remains the initial treatment option, providing histological diagnosis and immediate relief of tumor-related mass effect. Patients receiving surgery alone or surgery and external beam radiotherapy (EBRT) show improved overall survival (OS) and progression-free survival as compared to those undergoing a biopsy alone (p = 0.01 and p = 0.02, respectively). Yet, in many instances, patient and tumor-related parameters preclude complete resection. EBRT or stereotactic radiosurgery (SRS) shares a significant role in achieving local tumor control, not shown to impact OS in HPC patients. The benefits of SRS/EBRT are clearly limited to improved local tumor volume control and neurologic function, not affecting DNM or ENM development. SRS provides acceptable rates of local tumor volume control coupled with treatment safety and a patient-friendly apparatus and procedure. Single-session SRS is most effective for lesions measuring <2 cm in their largest diameter (10 cm3 volume), with prescription doses of at >15 Gy. Systemic HPC disease is managed with various chemotherapeutic, immunotherapeutic, and anti-angiographic agents, with limited success. We present a short discussion on CNS HPCs, focusing our discussion on available evidence regarding the role of microsurgical resection, EBRT, SRS, chemotherapy, and immunotherapy for upfront, part of adoptive hybrid surgery approach or for recurrent HPCs.
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Boyett D, Kinslow CJ, Bruce SS, Sonabend AM, Rae AI, McKhann GM, Sisti MB, Bruce JN, Cheng SK, Wang TJC. Spinal location is prognostic of survival for solitary-fibrous tumor/hemangiopericytoma of the central nervous system. J Neurooncol 2019; 143:457-464. [PMID: 31054100 PMCID: PMC7311186 DOI: 10.1007/s11060-019-03177-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/25/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prior studies have highlighted infratentorial tumor location as a prognostic factor for solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) of the central nervous system (CNS), and spinal location is considered a positive prognostic factor for other tumors of the CNS. While SFT/HPC of the CNS is known to frequently arise from the spinal meninges, there are no case series that report outcomes for spinally located CNS tumors, and their prognosis in relation to intracranial and other CNS-located tumors is unknown. OBJECTIVE To investigate outcomes for patients with SFT/HPC of the spinal meninges. METHODS The Surveillance, Epidemiology, and End-Results Program was used to identify patients with SFT/HPC within the CNS from 1993-2015. We retrospectively analyzed the relationship between tumor location (spinal vs. Brain and other CNS) and survival. RESULTS We identified 551 cases of CNS SFT/HPC, 64 (11.6%) of which were primary tumors of the spinal meninges. Spinal tumors were more likely than brain and other CNS tumors to be SFT vs. HPC (37.5 vs. 12%, p < 0.001), benign (42.2 vs. 20.3%, p < 0.001), and less than 5 cm (53.1 vs. 35.7%, p < 0.001). The 10-year survival rates for spinal and brain/other CNS tumors were 85 and 58%, respectively. Median survival time was significantly longer for spinal tumors (median survival not reached vs. 138 months, p = 0.03, HR = 0.41 [95% CI 0.18-0.94]). On multivariable analysis, spinal tumor location was associated with improved survival over tumors located in the brain and other CNS (HR = 0.36 [95% CI 0.15-0.89], p = 0.03). CONCLUSION Spinal tumor location is associated with improved survival in patients with SFT/HPC of the CNS. Larger institutional studies are necessary to characterize the relationship between tumor location and other relevant factors such as presentation and amenability to gross-total resection and adjuvant radiotherapy. Future studies exploring optimal management of spinally located tumors are also needed.
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Affiliation(s)
- Deborah Boyett
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Connor J Kinslow
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA
| | - Samuel S Bruce
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Adam M Sonabend
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA
| | - Ali I Rae
- Department of Neurological Surgery, Oregon Health & Sciences University, 3181 SW Sam Jackson Pkwy, Portland, OR, 97239, USA
| | - Guy M McKhann
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Michael B Sisti
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Jeffrey N Bruce
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Simon K Cheng
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Tony J C Wang
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA.
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Singh H, Patir R, Gupta A, Vaishya S. A Rare Case of Simultaneous Multifocal Craniospinal Hemangiopericytomas. Asian J Neurosurg 2018; 13:885-887. [PMID: 30283574 PMCID: PMC6159097 DOI: 10.4103/ajns.ajns_356_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
First reported case of simultaneous occurrence of hemangiopericytomas(HCP) at multiple sites of craniospinal axis in a thirty four year male is presented. Patient presented with neck pain for 1 year, and one episode of simple partial seizure involving his left lower limb. He was diagnosed as having HCP in right middle one third parasagittal region, and C4,5 vertebral bodies. Another lesion was present in L5 vertebra, which was radiologically similar to the cervical lesion, but not biopsy proven. High index of suspicion, and low threshold for screening, for coexistence of spinal HCP, in patients harboring cranial HCP's and complaints of back pain.
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Affiliation(s)
- Harnarayan Singh
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Rana Patir
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Anurag Gupta
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Sandeep Vaishya
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India
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Mashaly H, Zhang Z, Shaw A, Youssef P, Mendel E. Intraoperative Transpedicular Onyx Injection to Reduce Vascularity of a Thoracic Hemangiopericytoma After Unsuccessful Preoperative Endovascular Embolization: a Technical Report. Oper Neurosurg (Hagerstown) 2018; 14:E17-E22. [PMID: 29351687 DOI: 10.1093/ons/opx102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 04/05/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Hemangiopericytoma is a rare vascular tumor with central nervous system involvement representing only 1% of central nervous system tumors. They rarely affect the vertebral column. Complete surgical resection is the treatment of choice for hemangiopericytoma given their high rates of local recurrence. However, the high vascularity of such tumors with the risk of massive bleeding during surgery represents a significant challenge to surgeons. Therefore, preoperative endovascular embolization via the transarterial route has been advocated. CLINICAL PRESENTATION In the current study, we present a case of a T12 hemangiopericytoma that was managed by a 2-stage surgical resection, with the use of intraoperative transpedicular onyx injection to reduce intraoperative blood loss following an unsuccessful trial of preoperative endovascular embolization. CONCLUSION Preoperative endovascular embolization is not feasible in some cases due to the location of the segmental or radiculomedullary arteries in relation to tumor feeders and, rarely, small size of these arterial feeders. Percutaneous injection of onyx is an option. In this case report, we discuss direct intraoperative injection via a transpedicular route as a safe and effective method for decreasing the vascularity of some lesions and improving intraoperative blood loss.
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Affiliation(s)
- Hazem Mashaly
- Department of Neurological Surgery, The Ohio State University, Wexner Medical Center Columbus, Ohio.,Department of Neurological Surgery, Ain Shams University, Cairo, Egypt
| | - Zoe Zhang
- Department of Neurological Surgery, The Ohio State University, Wexner Medical Center Columbus, Ohio
| | - Andrew Shaw
- Department of Neurological Surgery, The Ohio State University, Wexner Medical Center Columbus, Ohio
| | - Patrick Youssef
- Department of Neurological Surgery, The Ohio State University, Wexner Medical Center Columbus, Ohio
| | - Ehud Mendel
- Department of Neurological Surgery, The Ohio State University, Wexner Medical Center Columbus, Ohio
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Ali HSM, Endo T, Endo H, Murakami K, Tominaga T. Intraspinal dissemination of intracranial hemangiopericytoma: Case report and literature review. Surg Neurol Int 2017; 7:S1016-S1020. [PMID: 28144476 PMCID: PMC5234272 DOI: 10.4103/2152-7806.195585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/04/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The authors report the case of a 53-year-old woman suffering from thoracic myelopathy caused by intraspinal dissemination of hemangiopericytoma. In literature, hemangiopericytoma is commonly found as an intracranial lesion, and often hematogenously metastasizes to the bone or liver; however, intradural spinal dissemination is extremely rare. CASE DESCRIPTION The patient presented with gait disturbance due to thoracic myelopathy 6 years after surgical treatment for intracranial hemangiopericytoma. Magnetic resonance imaging demonstrated intradural disseminated lesions compressing the spinal cord. Although the patient underwent resection of the intradural spinal tumor, the lesion was tightly adherent to the dorsal surface of the spinal cord. Therefore, it resulted in subtotal removal. Immediately after the surgery, symptoms related to the thoracic myelopathy resolved. The patient was free from disease progression for 14 months after whole spine radiotherapy. CONCLUSION Recognition of this type of progression is important in the clinical management of intracranial hemangiopericytoma because intradural spinal dissemination dramatically degrades neurological functions.
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Affiliation(s)
- Hosam Shata Mohanmed Ali
- Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan; Department of Neurosurgery, Mansoura University, Mansoura, Egypt
| | - Toshiki Endo
- Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan; Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Kensuke Murakami
- Department of Neurosurgery, Sendai Medical Center, Sendai, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan
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Joo MS, Rho YJ, Song SW, Koh YC, Roh HG, Lim SD. Metastatic Intracranial Hemangiopericytoma to the Spinal Column: A Case Report. Brain Tumor Res Treat 2016; 4:128-132. [PMID: 27867924 PMCID: PMC5114184 DOI: 10.14791/btrt.2016.4.2.128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/22/2016] [Accepted: 08/31/2016] [Indexed: 11/20/2022] Open
Abstract
Intracranial hemangiopericytoma (HPC) is a rare brain tumor with aggressive biologic behavior associated with high recurrence rate and often with extracranial metastasis. The most common sites of extracranial metastasis of the intracranial HPC are the long bones, lung, liver and abdominal cavity in the order of frequencies. Extracranial metastases usually occur long after the initial diagnosis of the primary tumor. Metastatic intracranial HPC to the vertebra has been rarely reported. We present a case of intracranial HPC metastasized to the L2 vertebral body 13 years after multiple surgical resections and radiotherapy of the primary intracranial HPC.
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Affiliation(s)
- Myung Sung Joo
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea
| | - Young Joon Rho
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea
| | - Sang Woo Song
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea
| | - Young-Cho Koh
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea
| | - Hong Gee Roh
- Department of Radiology, Konkuk University Medical Center, Seoul, Korea
| | - So-Dug Lim
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
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Fukuda Y, Watanabe K, Toyama Y, Mikami S, Matsumoto M. Metastasis of intracranial meningeal hemangiopericytoma to thoracic spine 17 years after surgical excision: a case report. J Orthop Sci 2015; 20:425-9. [PMID: 23943153 DOI: 10.1007/s00776-013-0450-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 07/09/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Yoshitsugu Fukuda
- Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
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Abstract
A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC). The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented.
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Affiliation(s)
- Raghvendra V Ramdasi
- Department of Neurosurgery, King Edward Memorial Hospital, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India
| | - Trimurti D Nadkarni
- Department of Neurosurgery, King Edward Memorial Hospital, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India
| | - Naina A Goel
- Department of Neuropathology, King Edward Memorial Hospital, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India
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Brigui M, Aldea S, Bernier M, Bennis S, Mireau E, Gaillard S. Two patients with a solitary fibrous tumor of the thoracic spinal cord. J Clin Neurosci 2013; 20:317-9. [DOI: 10.1016/j.jocn.2012.02.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 02/02/2012] [Accepted: 02/14/2012] [Indexed: 01/23/2023]
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Abstract
Abstract
BACKGROUND:
Intraspinal hemangiopericytoma (HPC) is a rare and malignant extra-axial tumor with a strong tendency to recur and metastasize. There is a paucity in the literature of large case series of patients with intraspinal HPCs.
OBJECTIVE:
We retrospectively analyzed the clinical radiological and histological features, classification, and treatment of 26 patients with HPCs in the spine.
METHODS:
Twenty-six patients with HPCs in the spine were treated at our institution between 1987 and 2010. Medical records were reviewed retrospectively to collect data on the clinical features, tumor morphology, surgical resection, recurrence, and follow-up.
RESULTS:
The 26 patients were predominantly male, and the mean age at diagnosis was 33.8 years. The intraspinal HPCs were divided into 3 types and 5 subtypes. Most of them involved the neighboring segments and/or caused bony erosion. All tumors were immunohistochemically positive for vimentin and negative for epithelial membrane antigen. All patients underwent at least 1 surgery, and most of them received postsurgical radiotherapy. The 5-year Kaplan-Meier rate of survival was 76%. The 5-year recurrence-free rate of survival was 29.4%. Only the tumor pathological grade was significantly associated with survival time and recurrence.
CONCLUSION:
High-grade tumors had a shorter survival time and recurred earlier than low-grade tumors. Surgical removal and postoperative radiotherapy are critical for the treatment of intraspinal HPCs. However, total resection may not necessary for these tumors. Stereotactic radiosurgery may be a good alternative to control the recurrent lesions.
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Affiliation(s)
- Huan-guang Liu
- Department of Neurosurgery Capital Medical University, Beijing, China
| | - An-chao Yang
- Department of Neurosurgery Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Neurosurgery Capital Medical University, Beijing, China
| | - Jun Yang
- Department of Neurosurgery Capital Medical University, Beijing, China
| | - Xiao-guang Qiu
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian-guo Zhang
- Department of Neurosurgery Capital Medical University, Beijing, China
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Moscovici S, Ramirez-DeNoriega F, Fellig Y, Rosenthal G, Cohen JE, Itshayek E. Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root: a case report and literature review. Spine (Phila Pa 1976) 2011; 36:E1534-9. [PMID: 21857403 DOI: 10.1097/BRS.0b013e31822dddf4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Review the presentation and diagnosis of an intradural extramedullary hemangiopericytoma of the thoracic spine. OBJECTIVE To present a rare case of intradural, subpial hemangiopericytoma in the thoracic spine, with a brief overview of the literature. SUMMARY OF BACKGROUND DATA Spinal intradural extramedullary hemangiopericytoma is rare entity that radiographically mimics nerve-sheath tumors. These lesions are typically diagnosed at surgery performed due to suspicion of tumor. METHODS A 20-year-old man who presented with back pain, leg weakness, and sphincter incontinence. MR imaging demonstrated an intradural extramedullary lesion at the T9-T10 level that was isointense on T1- and T2-weighted images and homogeneously enhancing after administration of gadolinium, with cystic components seen on T2-weighted images. The preoperative diagnosis was meningioma or schwannoma. RESULTS At surgery, the lesion was bluish and completely subpial, with apparent nerve root invasion. Pathological examination revealed a neoplasm adjacent to a nerve root with possible focal infiltration. Abundant reticulin fibers and widened, branching vascular channels imparting a staghorn appearance were seen. Up to five mitotic figures were counted in one high-power field. On immunostaining, the neoplastic cells were diffusely immunoreactive for CD99 and immunonegative for EMA, CD34, and S-100 protein. The pathological diagnosis was consistent with anaplastic hemangiopericytoma, WHO grade III. CONCLUSION This is the ninth report of spinal intradural hemangiopericytoma. The location of the neoplasm supports the hypothesis that hemangiopericytoma may arise from the spinal pial capillaries.
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