Spinal Hemangiopericytoma

Abstract

1 -Neurosurgeon from Sírio Libanês Hospital -São Paulo / SP / Brazil. 2 -Head and Neck Surgeon from Sírio Libanês Hospital -São Paulo / SP / Brazil. 3 -Neurologist from Sírio Libanês Hospital -São Paulo / SP / Brazil. 4 -Radiologist from Sírio Libanês Hospital -São Paulo / SP / Brazil. 5 -Neuropathologist from Sírio Libanês Hospital -São Paulo / SP / Brazil. RESUMO Introdução: A maioria dos Hemangiopericitomas (HPC) ocorre na pele ou no sistema musculoesquelético, enquanto que a topografia do Sistema Nervoso Central (SNC) é mais rara. Objetivo e Métodos: Nós descrevemos um paciente portador de um HPC espinhal volumoso, com compressão medular exuberante, se estendendo de C6 a T3, o qual foi levado para cirurgia. Resultados: O paciente foi submetido à cirurgia, via posterior, identificando um tumor sólido de consistência firme, vermelho-acastanhado, muito vascularizado, o qual foi delicadamente dissecado e ressecado totalmente em bloco. Exames histopatológico e imunohistoquímico revelaram HPC. Conclusão: HPCs espinhais são tumores raros, que ocorrem de maneira isolada, aderidos à dura-máter, mas que favorecem a ressecção completa, tendo em vista apresentarem bom plano de clivagem com tecidos circunjacentes. Palavras-chave: Neoplasia do SNC, tumor espinhal, hemangiopericitoma.ABSTRACT Introduction: Most hemangiopericytomas (HPC) are located in the musculoskeletal system and the skin, while the location in the central nervous system (CNS) is rare. Objective and Methods: We describe a patient suffering from a spinal extradural huge HPC, with marked spinal cord compression, extending from C6 to T3 level, who was elected to surgery. Results: Patient was submitted to surgery, via a posterior approach, indentifying a huge red-brown firm mass, highly vascular, that was softly dissected from surrounding tissues. Total gross removal was accomplished, with "in-block" resection, preserving neurological function, as shown by somatosensitive evoked potential. Histopathological examination and immunohistochemistry essay were performed confirming the diagnosis of Hemangiopericytoma. Conclusion: Spinal HPCs respond to approximately 8% of all HPC, tend to occur isolated and attached to spinal duramater, and usually present a good surgical cleavage between the tumor and the dura.