A Case Report of Meningeal Hemangiopericytoma: A 9-Year Journey from the Brain to the Spine

World Neurosurg. 2019 Feb:122:459-463. doi: 10.1016/j.wneu.2018.11.028. Epub 2018 Nov 14.

Abstract

Background: Hemangiopericytomas (HPCs) are rare and aggressive vascular mesenchymal tumors. Unlike meningiomas, which have a similar radiologic appearance, these tumors have a higher risk of local recurrence after resection, and distant metastasis can reach up to 23%. Metastases to the vertebral bones from an intracranial HPC are very rare, with so far only 9 cases reported in the literature.

Case description: We present the case of a 46-year-old man who was surgically treated for a presumed left parieto-occipital falx meningioma in 2008. He presented 9 years later with a thoracic vertebral mass that was causing relentless pain. Reexamination of the cranial pathology allowed correction of the diagnosis performed in 2008 to a meningeal HPC, and the spinal lesion was confirmed after surgery to be a metastatic tumor.

Conclusions: The literature lacks randomized controlled trials and large studies defining the natural history of HPC to draw clear recommendations for a precise management of the disease. However, en bloc resection followed by radiation therapy seems to provide the optimal treatment for a long disease-free survival.

Keywords: Brain tumor; Extra-axial tumor; Hemangiopericytoma; Solitary fibrous tumor; Spinal metastasis.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery
  • Hemangiopericytoma / diagnosis
  • Hemangiopericytoma / surgery*
  • Humans
  • Male
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / surgery*
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / pathology
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / secondary*
  • Spine / pathology
  • Spine / surgery*
  • Thoracic Vertebrae / pathology