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Spinal hemangiopericytoma: an institutional experience and review of literature

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Abstract

Purpose

Hemangiopericytoma is a rare tumor of CNS with potential for recurrence and widespread metastasis, even outside CNS with even rare involvement of spinal cord. This case series presents five patients to evaluate the clinical presentation, radiological features, management, pathology and outcome of spinal hemangiopericytomas.

Methods

Between 2004 and 2013, five patients underwent surgery for spinal hemangiopericytoma. Histopathological data were reviewed in all cases and clinical and follow-up details were collected from the data available in our department.

Results

There were three males and two females, including one pediatric patient. Three patients had dorsal spine involvement and two patients had involvement of cervical spine. There were two patients with intradural extramedullary tumors, one patient each with pure intramedullary tumor, pure extradural tumor and both intra and extradural tumor. All of them presented with motor weakness. Gross total resection of the tumor was done in three patients. Four patients received post-operative radiotherapy. Histopathology showed anaplastic tumor in four cases with high MIB-1 LI. Most of them were positive for CD34, mic-2 and bcl-2. Three patients who underwent gross total resection improved significantly in the follow-up period. Two patients who underwent subtotal resection expired due to spread of their disease.

Conclusion

Spinal hemangiopericytoma is a rare tumor. Strong clinical suspicion is required to diagnose it pre-operatively. Gross total resection is the goal and radiotherapy should be given in case of residual tumor or high-grade tumors.

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References

  1. Ladha AM, Guthrie BL, Ewend MG (2011) Meningeal sarcoma and meningeal hemangiopericytoma. In: Winn H Richard (ed) Youmans neurological surgery, 6th edn. Elsevier, Saunders, Philadelphia, pp 1426–1449

  2. Stout AP, Murray MR (1942) Hemangiopericytoma: a vascular tumor featuring Zimmerman’s pericytes. Ann Surg 116(1):26–33

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Fabiani A, Favero M, Trebini F (1980) On the primary meningeal tumors with special concern to the hemangiopericytoma pathology and biology. Zentralbl Neurochir 41:273–284

    CAS  PubMed  Google Scholar 

  4. Kruse F Jr (1961) Hemangiopericytoma of the meninges (angioblastic meningioma of Cushing and Eisenhardt): clinicopathologic aspects and follow-up studies in 8 cases. Neurology 11:771–777

    Article  PubMed  Google Scholar 

  5. Jaaskelainen J, Servo A, Haltia M et al (1985) Intracranial hemangiopericytoma: radiology, surgery, radiotherapy, and outcome in 21 patients. Surg Neurol 23:227–236

    Article  CAS  PubMed  Google Scholar 

  6. Kochanek S, Schroder R, Firsching R (1986) Hemangiopericytoma of the meninges: histopathological variability and differential diagnosis. Zentralbl Neurochir 47:183–190

    CAS  PubMed  Google Scholar 

  7. Ackerman PD, Khaldi A, Shea JF (2011) Intradural hemangiopericytoma of the thoracic spine: a case report. Spine J 11(7):e9–e14

    Article  PubMed  Google Scholar 

  8. Betchen S, Schwartz A, Black C, Post K (2002) Intradural hemangiopericytoma of the lumbar spine: case report. Neurosurgery 50:654–657

    PubMed  Google Scholar 

  9. Chou CW, Hsu SPC, Lin SC et al (2009) Primary intradural hemangiopericytoma with intramedullary invasion. J Chin Med Assoc 72:536–554

    Article  PubMed  Google Scholar 

  10. Ciappetta P, Celli P, Palma L et al (1985) Intraspinal hemangiopericytomas. Report of two cases and review of the literature. Spine 10:27–31

    Article  CAS  PubMed  Google Scholar 

  11. Dufour H, Metellus P, Fuentes S et al (2001) Meningeal hemangiopericytoma: a retrospective study of 21 patients with special review of the postoperative external radiotherapy. Neurosurgery 48:756–763

    CAS  PubMed  Google Scholar 

  12. Fitzpatrick D, Mahajan J, Lewkowitz M et al (2009) Intradural hemangiopericytoma of the lumbar spine: a rare entity. AJNR 30:152–154

    Article  CAS  PubMed  Google Scholar 

  13. Kashiwazaki D, Hida K, Yano S et al (2007) Subpial hemangiopericytoma with marked extramedullary growth: case report. Neurosurgery 61:1336–1337

    Article  Google Scholar 

  14. Pitlyk PJ, Dockery MB, Miller RH (1965) Hemangiopericytoma of the spinal cord: report of three cases. Neurology 15:649–653

    Article  CAS  PubMed  Google Scholar 

  15. Someya M, Sakata K, Oouchi A et al (2001) Four cases of meningeal hemangiopericytoma treated with surgery and radiotherapy. Jpn J Clin Oncol 31:548–552

    Article  CAS  PubMed  Google Scholar 

  16. Zhao Y, Zhao JZ (2007) Clinical and pathological characteristics of primary intraspinal hemangiopericytoma and choice of treatment. Chin Med J (Engl) 120:115–119

    Google Scholar 

  17. Shirzadi A, Drazin D, Gates M et al (2013) Surgical management of primary spinal hemangiopericytomas: an institutional case series and review of the literature. Eur Spine J 22(Suppl 3):S450–S459

  18. Liu HG, Yang AC, Chen N et al (2013) Hemangiopericytomas in the spine: clinical features, classification, treatment, and long-term follow-up in 26 patients. Neurosurgery 72(1):16–24 (discussion 24)

  19. Schirger A, Uihlein A, Parker HL et al (1958) Hemangiopericytoma recurring after 26 years; report of case. Proc Staff Meet Mayo Clin 33(13):347–352

    CAS  PubMed  Google Scholar 

  20. Kriss FC, Kahn DR, Schneider RC (1968) Value of angiography in intraspinal mediastinal hemangiopericytoma. Case report. J Neurosurg 29:535–539

    Article  Google Scholar 

  21. Fathie K (1970) Hemangiopericytoma of the thoracic spine; case report. J Neurosurg 32(3):371–374

    Article  CAS  PubMed  Google Scholar 

  22. Gerner RE, Moore GE, Pickren JW (1974) Hemangiopericytoma. Ann Surg 179(2):128–132

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Harris DJ, Fornasier VL, Livingston KE (1978) Hemangiopericytoma of the spinal canal. Report of three cases. J Neurosurg 49(6):914–920

    Article  CAS  PubMed  Google Scholar 

  24. Stern MB, Grode ML, Goodman MD (1980) Hemangiopericytoma of the cervical spine: report of an unusual case. Clin Orthop Relat Res 151:201–204

    PubMed  Google Scholar 

  25. Cappabianca P, Maiuri F, Pettinato G et al (1981) Hemangiopericytoma of the spinal canal. Surg Neurol 15(4):298–302

    Article  CAS  PubMed  Google Scholar 

  26. Muraszko KM, Antunes JL, Hilal SK et al (1982) Hemangiopericytomas of the spine. Neurosurgery 10(4):473–479

    Article  CAS  PubMed  Google Scholar 

  27. Bridges LR, Roche S, Nashef L et al (1988) Haemangiopericytic meningioma of the sacral canal: a case report. J Neurol Neurosurg Psychiatry 51(2):288–290

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Salvati M, Ciappetta P, Artico M et al (1991) Intraspinal hemangiopericytoma: case report and review of the literature. Neurosurg Rev 14(4):309–313

    Article  CAS  PubMed  Google Scholar 

  29. Akhaddar A, Chakir N, Amarti A et al (2002) Thoracic epidural hemangiopericytoma. Case report. J Neurosurg Sci 46(2):89–92

    CAS  PubMed  Google Scholar 

  30. Ijiri K, Yuasa S, Yone K et al (2002) Primary epidural hemangiopericytoma in the lumbar spine: a case report. Spine (Phila Pa 1976) 27(7):E189–E192

  31. Mohammadianpanah M, Torabinejad S, Bagheri MH et al (2004) Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report. Sao Paulo Med J 122(5):220–222

    Article  PubMed  Google Scholar 

  32. Wu W, Shi JX, Cheng HL et al (2009) Hemangiopericytomas in the central nervous system. J Clin Neurosci 16(4):519–523

    Article  PubMed  Google Scholar 

  33. Moscovici S, Ramirez-DeNoriega F, Fellig Y et al (2011) Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root: a case report and literature review. Spine (Phila Pa 1976) 36(23):1534–1539

  34. McMaster MJ, Soule EH, Ivins JC (1975) Hemangiopericytoma. A clinicopathologic study and long-term follow-up of 60 patients. Cancer 36(6):2232–2244

    Article  CAS  PubMed  Google Scholar 

  35. Ecker RD, Marsh WR, Pollock BE et al (2003) Hemangiopericytoma in the central nervous system: treatment, pathological features, and long-term follow up in 38 patients. J Neurosurg 98(6):1182–1187

    Article  PubMed  Google Scholar 

  36. Zweckberger K, Jung CS, Mueller W et al (2011) Hemangiopericytomas grade II are not benign tumors. Acta Neurochir (Wien) 153(2):385–394

    Article  CAS  Google Scholar 

  37. Giannini C, Rushing EJ, Hainfellner JA (2007) Haemangiopericytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO classification of tumours of the central nervous system, 4th edn. International Agency for Research on Cancer (IARC), Lyon, pp 178–180

  38. Sundaram C, Shantveer UG, Megha US et al (2010) A clinicopathological and immunohistochemical study of the central nervous system hemangiopericytomas. J Clin Neurosci 17:469–472

    Article  PubMed  Google Scholar 

  39. Guthrie BL, Ebersold MJ, Scheithauer BW et al (1989) Meningeal hemangiopericytoma: histopathological features, treatment, and long-term follow-up of 44 cases. Neurosurgery 25:514–522

    Article  CAS  PubMed  Google Scholar 

  40. Kim JH, Jung HW, Kim YS et al (2003) Meningeal hemangiopericytomas: long-term outcome and biological behavior. Surg Neurol 59(1):47–54

    Article  PubMed  Google Scholar 

  41. Soyuer S, Chang EL, Selek U et al (2004) Intracranial meningeal hemangiopericytoma: the role of radiotherapy: report of 29 cases and review of the literature. Cancer 100:1491–1497

    Article  PubMed  Google Scholar 

  42. Schiariti M, Goetz P, El-Maghraby H et al (2011) Hemangiopericytoma: long-term outcome revisited. Clinical article. J Neurosurg 114(3):747–755

    Article  PubMed  Google Scholar 

  43. Bastin KT, Mehta MP (1992) Meningeal hemangiopericytoma: defining the role for radiation therapy. J Neurooncol 14(3):277–287

    Article  CAS  PubMed  Google Scholar 

  44. Mena H, Ribas JL, Pezeshkpour GH et al (1991) Hemangiopericytoma of the central nervous system: a review of 94 cases. Hum Pathol 22(1):84–91

    Article  CAS  PubMed  Google Scholar 

  45. Combs SE, Thilmann C, Debus J et al (2005) Precision radiotherapy for hemangiopericytomas of the central nervous system. Cancer 104(11):2457–2465

    Article  PubMed  Google Scholar 

  46. Coffey RJ, Cascino TL, Shaw EG (1993) Radiosurgical treatment of recurrent hemangiopericytomas of the meninges: preliminary results. J Neurosurg 78(6):903–908

    Article  CAS  PubMed  Google Scholar 

  47. Cohen Y, Lichtig C, Robinson E (1972) Combination chemotherapy in the treatment of metastatic hemangiopericytoma. Oncology 26(2):180–187

    Article  CAS  PubMed  Google Scholar 

  48. Kroh H, Figols J, Sobieraj A (1997) Intracranial hemangiopericytomas. Histological and immunohistochemical study. Folia Neuropathol 35(2):121–127

    CAS  PubMed  Google Scholar 

  49. Rajaram V, Brat DJ, Perry A (2004) Anaplastic meningioma versus meningeal hemangiopericytoma: immunohistochemical and genetic markers. Hum Pathol 35:1413–1418

    Article  CAS  PubMed  Google Scholar 

  50. Sibtain NA, Butt S, Connor SEJ (2007) Imaging features of central nervous system hemangiopericytomas. Eur Radiol 17:1685–1693

    Article  CAS  PubMed  Google Scholar 

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None of the authors has any potential conflict of interest.

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Correspondence to Pankaj Kumar Singh.

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Das, A., Singh, P.K., Suri, V. et al. Spinal hemangiopericytoma: an institutional experience and review of literature. Eur Spine J 24 (Suppl 4), 606–613 (2015). https://doi.org/10.1007/s00586-015-3789-1

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  • DOI: https://doi.org/10.1007/s00586-015-3789-1

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