[What's new in the management of meningeal solitary fibrous tumor/hemangiopericytoma?]

Bull Cancer. 2020 Dec;107(12):1260-1273. doi: 10.1016/j.bulcan.2020.09.011. Epub 2020 Nov 5.
[Article in French]

Abstract

Meningeal fibrous solitary tumors/hemangiopericytoma are rare and aggressive mesenchymal neoplasms considered as sarcomas. They represent less than 1% of intracranial tumors and derive from the pericytes of Zimmerman which permit capillary contraction. They tend to occur more often in males in the fifth decade. They are often revealed by intracranial hypertension. Some scannographic and MRI characteristics permit to distinguish meningeal fibrous solitary tumor/hemangiopericytoma from other meningeal tumors. Meningeal hemangiopericytoma and fibrous solitary tumors were considered as different entities until 2016. Following the discovery of an identical genetic event, the locus 12q13 chromosome inversion leading to a NAB2-STAT6 fusion with nuclear immunoreactivity for STAT6 protein, the 2016 WHO classification defines these tumors as a single entity. Meningeal fibrous solitary tumors/hemangiopericytoma have a high recurrence rate. Long-term recurrences may occur. Local relapses are more frequent than extracranial metastasis. A multimodal management is recommended to treat a localized disease. It involves a complete resection followed by adjuvant radiotherapy. When local recurrences occur, surgery or stereotactic radiosurgery permit sometimes a local control. Metastatic disease has a poor prognostic and a weak chimiosensitivity. Targeted therapies, like pazopanib, are a hopeful option.

Keywords: Fusion NAB2-STAT6; Hémangiopéricytomes/tumeurs fibreuses solitaires méningés; Meningeal hemangiopericytoma/fibrous solitary tumor; NAB2-STAT6 fusion; Pazopanib; Targeted therapy; Thérapies ciblées.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Chromosome Inversion
  • Chromosomes, Human, Pair 12
  • Clinical Trials as Topic
  • Embolization, Therapeutic
  • Female
  • Hemangiopericytoma* / diagnostic imaging
  • Hemangiopericytoma* / genetics
  • Hemangiopericytoma* / pathology
  • Hemangiopericytoma* / therapy
  • Humans
  • Intracranial Hypertension / etiology
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms* / diagnostic imaging
  • Meningeal Neoplasms* / genetics
  • Meningeal Neoplasms* / pathology
  • Meningeal Neoplasms* / therapy
  • Neoplasm Recurrence, Local
  • Oncogene Proteins, Fusion / genetics
  • Protein Kinase Inhibitors / therapeutic use
  • Radiotherapy, Adjuvant
  • Rare Diseases* / diagnostic imaging
  • Rare Diseases* / genetics
  • Rare Diseases* / pathology
  • Rare Diseases* / therapy
  • Repressor Proteins / genetics
  • STAT6 Transcription Factor / genetics
  • Solitary Fibrous Tumors* / diagnostic imaging
  • Solitary Fibrous Tumors* / genetics
  • Solitary Fibrous Tumors* / pathology
  • Solitary Fibrous Tumors* / therapy
  • Tomography, Emission-Computed
  • Ultrasonography

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • NAB2 protein, human
  • Oncogene Proteins, Fusion
  • Protein Kinase Inhibitors
  • Repressor Proteins
  • STAT6 Transcription Factor
  • STAT6 protein, human