Meningeal Hemangiopericytoma: Histopathological Features, Treatment, and Long-Term Follow-up of 44 Cases

Abstract

Forty-four cases of meningeal hemangiopericytoma that were treated between 1938 and 1987 are reviewed. Fifty-five percent of these tumors occurred in men. The average age of the patients at diagnosis was 42 years. The average duration of preoperative symptoms was 11 months. Symptoms were related to tumor location, which was similar to that of meningioma. The operative mortality was 9% overall, and has been zero since 1974 (18 patients). The average time before the first recurrence was 47 months, with the recurrence rates at 1, 5, and 10 years after surgery being 15, 65, and 76%, respectively. Ten patients have developed extraneural metastasis, mostly to lung and bone, at an average of 99 months after the first operation. The 10- and 15-year rates of metastasis were 33 and 64%, respectively. The average survival period has been 84 months, with survival rates at 5, 10, and 15 years after surgery of 67, 40, and 23%, respectively. The histological diagnosis of the tumor was not related to survival or recurrence and did not change with recurrence. Tentorial and posterior fossa tumors tended to be more lethal. Total tumor resection favorably affected recurrence and survival, as opposed to subtotal resection. Metastasis adversely affected survival, and was followed by death at an average of 24 months after its diagnosis. Radiation therapy after the first operation extended the average time before first recurrence from 34 to 75 months, and extended survival from 62 to 92 months.

The role of radiosurgery for hemangiopericytomas

“…10,12,20 Hemangiopericytomas, however, are much more aggressive lesions, associated with high rates of local or distant recurrences, [1][2][3]5,[10][11][12]17,18,20,23,27,31 and thus can behave similarly to other malignant lesions. 24 Resection is the initial treatment of choice, 26 but the highly vascular nature of the lesion and the location of some along the skull base results in mortality rates between 9 and 24%.…”

“…24 Resection is the initial treatment of choice, 26 but the highly vascular nature of the lesion and the location of some along the skull base results in mortality rates between 9 and 24%. 12,14,23,25 Furthermore, the median time from resection to recurrence is 12 months, 8 and distant metastases have been noted to appear between a mean of 63 and 99 months after initial diagnosis. 7,12,14,23,25 Because of the recurrent nature of these lesions, exter-S. D. Chang and G. T. Sakamoto nal-beam radiotherapy has been used in the postoperative setting.…”

Hemangiopericytoma in the Lateral Ventricle -Case Report-

“…3,7,8,10,12,20) Total resection of HPC and adjuvant radiotherapy are effective. 8,20) Local control rates were 84% for total resections and 38% for partial resections (non-significant) 5 years after surgery, and no local recurrence was found after total resection and adjuvant radiotherapy, whereas local recurrence was found in 45% of patients without adjuvant radiotherapy after total resection (non-significant). 20) Preoperative radiotherapy caused tumor shrinking, resulting in less bleeding during surgery.…”

“…18) Intracranial HPCs are especially uncommon, consisting of approximately 2% of meningeal tumors, 8,11) and less than 1% (0.2% in Japan) of all intracranial tumors. Intracranial HPCs bear many similarities to meningiomas, such as growth with attachment to the dura mater, commonly in the supratentorial component, adhering to the falx, sagittal sinus, 6,8,10) and macroscopically distinct appearance from the adjacent brain tissue. Intracranial HPCs were defined as histologically and immunohistochemically distinct from meningiomas after the first case of HPC arising from the dura mater was reported.…”

Meningeal Hemangiopericytomas and Meningomas: a Comparative Immunohistochemical and Genetic Study

“…It has been reported to represent 2 to 4% of meningeal tumors, comprising less than 1% of all intracranial tumors (Guthrie et al, 1989). Epidemiological studies reports that MHPC are rare tumors with lower average than meningiomas (MNGs) (Jazayeri et al, 2013) .…”