Intracranial meningeal hemangiopericytoma: Recurrences at the initial and distant intracranial sites and extraneural metastases to multiple organs

Abstract

Regardless of the controversial pathogenesis, intracranial meningeal hemangiopericytoma (M-HPC) is a rare, highly cellular and vascularized mesenchymal tumor that is characterized by a high tendency for recurrence and extraneural metastasis, despite radical excision and postoperative radiotherapy. M-HPC shares similar clinical manifestations and radiological findings with meningioma, which causes difficulty in differentiation of this entity from those prognostically favorable mimics prior to surgery. Treatment of M-HPC, particularly in metastatic settings, remains a challenge. A case is described of primary M-HPC with recurrence at the initial and distant intracranial sites and extraneural multiple-organ metastases in a 36-year-old female. The metastasis of M-HPC was extremely extensive, and to the best of our knowledge this is the first case of M-HPC with delayed metastasis to the bilateral kidneys. The data suggests that preoperative computed tomography and magnetic resonance imaging could provide certain diagnostic clues and useful information for more optimal treatment planning. The results may imply that novel drugs, such as temozolomide and bevacizumab, as a component of multimodality therapy of M-HPC may deserve further investigation.

Intracranial Multiple Sites Recurrence and Extracranial Multiple Organs Metastasis of Intracranial Hemangiopericytoma

“…There are another reports that postoperative radiotherapy is effective in local-recurrence control (LC) [7,8] , specially despite of the degree of resection [9] . No development of intracranial HPC persists to 5 years after first operation and postoperative radiotherapy, similar to another case report [10] with extracranial multiple organs metastasis. Cyber knife, compared with Intensity-modulated radiation therapy and Gamma knife radiotherapy, may be reveal dramatic effect in controlling development of intracranial metastatic HPC in present case, and prompts the potential application prospect in treatment of HPC.…”

“…Anti-angiogenic agents, another kind of novel drugs such as sunitinib and pazopanib, have been also utilized to treated to this disease [12] . For multiple organs metastasis of intracranial HPC, CIK therapy may be a potential treatment because of the resembling Immuno-histochemical features of different organs metastatic tumor from HPC [10] . The Immuno-histochemical results from renal and spinal metastatic tumor in the present case are similar, and CIK therapy appears stable effect for almost 12 months.…”

Hemangiopericitoma / tumor fibroso solitario: presentación de caso y revisión de la literatura

“…Debido a sus similitudes clínicas y radiológicas, es difícil diferenciar a los HPC/TFS de los meningiomas. Radiográficamente, los HPC/TFS se presenta como una masa extraaxial demarcada con fijación dural, un margen multilobulado y con reforzamiento acentuado por medios de contraste en resonancias magnéticas y tomografías computarizadas 27,28 . En T1, la lesión suele presentarse isointensa o ligeramente hiperintensa, atribuido a la alta celularidad 25 .…”

Radiation Therapy of Meningeal Hemangiopericytomas (Literature Review and Clinical Observation)

“…Головные боли, судорожные приступы, очаговая неврологическая симптоматика -все это может быть симптомами болезни [9]. Вдобавок, до 20 % ге-мангиоперицитом способны метастазировать отда-ленно -обычно в печень, легкие, кости скелета [5,7,9], но также встречаются редкие варианты метастазиро-вания, в частности в почки [10,11].…”