Extra- and intracranial dumbbell-shaped hemangiopericytoma

Abstract

Hemangiopericytomas are malignant tumors arising from pericytic cells and account for less than 1% of all vascular neoplasms. We report a rare case of an extra- and intracranial dumbbell-shaped hemangiopericytoma originating from the soft tissue of the neck and penetrating the skull base with invasion into the posterior cranial fossa. The 59-year-old female patient presented with a large pulsating neck mass and reported weakness, abnormal fatigue and headache. MRI revealed an inhomogeneously enhancing tumor and cerebral angiography showed intensive vascularization. Preoperative embolization was performed in order to decrease the operative blood loss. The tumor was operated via a far lateral approach through an osteoclastic suboccipital craniotomy. Total resection of both the intra- and extracranial part of the neoplasm (grade I by Simpson) could be achieved. The histopathological analysis revealed a mesenchymal, hypervascular tumor with the classic staghorn vascular pattern. In this article, we discuss the clinical presentation and multidisciplinary management of hemangiopericytoma and describe the radiological and pathological features of this tumor entity.

Mid‐occipital localization of extra‐intracranial hemangiopericytoma

“…With the exception of intracranial HPC, a distinct histopathologic entity classified as non‐menigothelial tumours of the meninges by the WHO classification of tumours affecting the central nervous system (2003), extracranial HPCs most commonly develop in the sinonasal region and more rarely they affect the neurocranium. Although some cases of temporal or suboccipital HPCs have been previously reported, 1,2 we did not find in the literature a mid‐occipital localization as in the present case.…”

Intraventricular Hemangiopericytoma in the Trigone of the Right Lateral Ventricle

“…7,8 This procedure will reduce intraoperative bleeding, 9 although the dominant internal carotid arterial blood supply of these tumors often deems them unsuitable for this treatment. 10 HPC is difficult to differentiate from meningioma by neuroimaging methods.…”

Concurrent Cochlear Implantation with Resection of Skull Base Hemangiopericytoma following Sudden Deafness in an Only Hearing Ear

“…5,[7][8][9][10] Skull base or temporal bone HPCs are very rare, with fewer than 15 cases reported in the literature. [11][12][13][14][15][16] Only two cases with significant intracranial extension of an ITF HPC are reported in the literature. 13,14 This is to be distinguished from primary intracranial HPC or distant metastasis.…”

“…[5][6][7][8][9][10] HPC involving the skull base is very rare, with less than 15 cases reported in the literature, only two of which had significant intracranial extension. [11][12][13][14][15][16] Hearing loss attributable to skull base HPC has been described in only two cases, both low-grade tumors occurring in the middle ear space. 15,16 Cochlear implantation (CI) at the time of tumor resection is well characterized in the case of acoustic neuroma, though there are few reports of concurrent CI following ablative surgery for other tumors.…”