Endovascular Preoperative Embolization of Orbital Hemangiopericytoma With n-Butyl Cyanoacrylate Glue

Abstract

Hemangiopericytoma is an uncommon neoplasm that may present in myriad locations, including the lower extremities, pelvic area, and the head and neck area, including the orbit.1 Orbital hemangiopericytoma is often described as synonymous with orbital solitary fibrous tumor, giant cell angiofibroma, and fibrous histiocytoma, as they all belong to a spectrum of collagen-rich fibroblastic tumors that are often CD34-positive and have overlapping histopathologic features.2 Many cases of orbital hemangiopericytoma have been reported in the literature along with various surgical approaches, long-term outcomes, and techniques to manage recurrence; however, few have discussed preoperative embolization.1,3-5 Intraoperative hemorrhage is a concern in both the congenital and the adult form of these cases6,7 and may be an indication for preoperative embolization. A unique case of preoperative embolization was presented with n-butyl cyanoacrylate for surgical resection of a large orbital hemangiopericytoma in a 58-year-old woman.

Preoperative transarterial embolization of a recurrent orbital solitary fibrous tumor with significant hypervascularity: a case report

“…The endovascular approach is more effective for tumors in the orbit. Compared with previous reposts [ 1 , 4 – 6 ], we demonstrated a large intraconal mass with multiple feeder vessels arising from 4 points of origin (Table 1 ), including main feeder vessels with numerous tangled branches arising from the ophthalmic artery and the IMA. Because the points of entry of the vessels from ophthalmic artery were too thin for the microcatheter to pass through, liquid Onyx was an effective means of embolizing these tangled feeder vessels due to its slow precipitation properties [ 1 ].…”

“…Embolization is an alternative approach to minimize intraoperative hemorrhage and improve the gross total removal (GTR) rate. There are few reports of transarterial embolization of orbital SFTs; only 4 have been published in English [ 1 , 4 – 6 ]. In this study, we successfully resected a large, recurrent orbital SFT with multiple feeder vessels after transarterial embolization.…”

Intraorbital solitary fibrous tumor requiring preoperative embolization of feeding artery

“…As adjunctive therapy, postoperative radiation has been recommended for residual tumor tissue. [13] If total removal of the tumor is achieved – as in our case – radiation therapy is reserved for recurrence, and long-term follow-up is essential.…”

Identification of Intraorbital Arteries in Pediatric Age by High Resolution Superselective Angiography

“…This is the case when embolization of collateral branches of the OA is required. Transarterial embolization (alone or in support of surgery) of the OA and of its collateral branches has been successfully carried out to treat a variety of diseases like hemangioblastomas, 13,14 hemangiopericytomas, 15 orbital varices, 16 meningiomas, 17 nasal angiofibroma, 17 and arterovenous malformation/fistulae. 6,18,19 The risk to inadvertently compromise vision occluding the central retinal artery, 18,19 however, must be kept in mind and a good knowledge of the arterial anatomy as showed by angiography can assist to prevent such complication.…”