Hemangiopericytoma of the sella mimicking pituitary adenoma: case report and review of the literature

Background: Solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is a rare tumor which originates from the walls of capillaries and has historically been thought to be able to occur anywhere in the body that blood vessels are found. It is rarely found in the sellar region. Case Description: InS this report, we present the first case of this tumor occurring in the sellar region of a pediatric patient. This 12-year-old male presented with progressive vision loss which prompted surgical resection after a sellar lesion was discovered on imaging. The initial transsphenoidal approach resulted in subtotal resection and the patient experienced reoccurrence within 3 months. He underwent an orbitozygomatic craniotomy to achieve gross total tumor resection. Conclusion: We conducted a literature review of intracranial SFT/HPC in the pediatric population and found it to be an extremely rare occurrence, with <30 cases reported. The incidence of SFT/HPC occurring in the sellar region for any age group was also found to be a rare entity. Treatment recommendations for this tumor are also scarce, based on retrospective chart reviews from the adult population. The role for adjuvant radiation has mixed results.

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“…Several journal articles have confirmed the validation of the diagnosis of intracranial and extracranial SFT. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Pediatric sellar solitary fibrous tumor/ hemangiopericytoma: A rare case report and review of the literature

Ghanchi

Patchana

Christian

et al. 2020

Surgical Neurology International

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“…Although they generally arise from the dura of the parasagittal and falcine regions,10 there are case reports of HPCs arising primarily in the cerebral parenchyma,11–13 pituitary fossa,10 14 15 cavernous sinus,16 cerebellum,17 pineal region,1 ventricular system18 and trigeminal nerve 19. In addition, they may present with acute subdural haematoma20 and intracerebral haemorrhage 21–24…”

Section: Discussionmentioning

confidence: 99%

What lies beneath

et al. 2013

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Haemangiopericytomas are a group of aggressive soft tissue sarcomas that originate from the pericytes in the walls of capillaries. Local invasion of the surrounding structures is not uncommon. Symptoms depend on the location, size and grade of tumour. Coexistence with a benign tumour in the same location is very rare. We report an interesting case of occipital scalp lipoma with an underlying torcular haemangiopericytoma and skull defect.

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“…1) Visual disturbance followed by headache is the most common presenting symptom of sellar SFT or HPC. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] As with other suprasellar tumors, these tumors often compress the pituitary gland and stalk. Therefore, pituitary dysfunction is also a common symptom.…”

Section: Fig 2 Histology and Immunohistochemistry He Staining Shows Spindle-shaped Cells Arranged Around The Blood Vessels (A) (×200) Prementioning

confidence: 99%

“…To date, there are only 17 case reports of sellar and suprasellar SFT or HPC published in the English literature since 2001. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Most of these tumors reportedly occur in middle aged patients, with higher preponderance in male individuals, as shown in Table 1. We present the case of a sellar SFT or HPC in an 87-year-old woman who achieved treatment efficacy with fractionated gamma knife radiosurgery after partial resection of the tumor.…”

Section: Introductionmentioning

confidence: 99%

Solitary Fibrous Tumor or Hemangiopericytoma of the Sella in an Older Patient Treated with Partial Removal Followed by Fractionated Gamma Knife Radiosurgery

Thapa

Shimizu

Kitazono

et al. 2021

NMC Case Report Journal

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Solitary fibrous tumor (SFT) or hemangiopericytoma (HPC) is a rare fibroblastic tumor of mesenchymal origin. SFT or HPC comprises <1% of all primary central nervous system tumors. SFT or HPC of the sellar or suprasellar region is even more unusual. We herein report a sellar SFT or HPC in an octogenarian who achieved favorable progress with partial removal followed by fractionated gamma knife radiosurgery. An 87-year-old woman presented with occasional headache and visual field defects. A rapidly growing tumor of the sella turcica was diagnosed. The patient underwent endoscopic transnasal transsphenoidal surgery; however, only partial resection of the tumor was possible, as it was fibrous and hard with increased vascularity. A histological examination confirmed the tumor to be grade II SFT or HPC. Two months after the resection, the residual tumor grew rapidly. Given the patient's advanced age, re-surgery was not the preferred option; thus, fractionated gamma knife radiosurgery (marginal dose, 30 Gy in five fractions) was performed. MRI and visual field examination performed 3 months after irradiation revealed tumor shrinkage and improvement in the visual field, respectively. One year and three months after irradiation, the tumor continued to shrink and her visual field had improved. Taking age into consideration, partial resection with fractionated gamma knife radiosurgery was the more appropriate choice for both local tumor control and the safety of the optic apparatus.

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Hemangiopericytoma of the sella mimicking pituitary adenoma: case report and review of the literature

Cited by 18 publications

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Pediatric sellar solitary fibrous tumor/ hemangiopericytoma: A rare case report and review of the literature

Pediatric sellar solitary fibrous tumor/ hemangiopericytoma: A rare case report and review of the literature

What lies beneath

Solitary Fibrous Tumor or Hemangiopericytoma of the Sella in an Older Patient Treated with Partial Removal Followed by Fractionated Gamma Knife Radiosurgery

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