Giant Retroperitoneal Hemangiopericytoma with Paraneoplastic Gynecomastia

Abstract

We report on a 38-year-old patient with a giant retroperitoneal hemangiopericytoma associated with bilateral paraneoplastic gynecomastia, which led to an almost uncontrollable hemorrhage on initial surgery due to the extreme hypervascularity of the process. After angiographic evaluation and superselective embolization, a complete surgical excision of a hemangiopericytoma weighing almost 1,000 g could be achieved. To reduce the risk of recurrence adjuvant radiotherapy with 49 Gy followed. Follow-up of 24 months showed no sign of recurrence on CT scans. To our knowledge this is the first reported case of hemangiopericytoma associated with a paraneoplastic syndrome. The literature and the therapeutic concepts are presented and discussed.

Hemangiopericytoma arising from the wall of the urinary bladder

“…The vast majority (75-95%) of HPCs presents as a painless mass, and the remainder trigger local symptoms. Our patient had a painless mass, hematuria, and frequency [3].…”

Hemangiopericitoma: reporte de 3 casos

“…Puede aparecer a cualquier edad pero mayormente entre la cuarta y quinta década, y sin predilección por sexo 6 . En nuestra serie presentamos un caso a los 25 años.…”

“…Microscópicamente tiene desde grandes espacios sinusoidales de paredes delgadas hasta canales vasculares del tamaño de capilares. Rodeando estas estructuras existen abundantes células redondas, fusiformes, dispuestas al azar separadas de las células endoteliales de los espacios vasculares mediante una membrana basal, y de las otras células por fibras de reticulina y colágeno 6 . Mediante tinción con plata se observa el tejido conectivo para demostrar la localización extraluminal de estas células redondas, diferencián-dolo de los hemangioendoteliomas en los cuales son intraluminales 2 .…”

Malignant Retroperitoneal Hemangiopericytoma: Report of a 73 Years Old Woman and Review of Literature

“…Pain or tenderness usually occurs in the late stage of the disease (7). Paraneoplastic syndromes were reported in some cases of HPC and include hypoglycemia which is resolved upon resection (8), hypertension, and gynecomastia due to production of tumor insulin-like growth factor I and II, and rennin (9,10).…”