Malignant hemangiopericytoma in the pelvic cavity successfully treated by combined-modality therapy: report of a case

Recurrent Omental Hemangiopericytoma: A Therapeutic Challenge

Hemangiopericytomas are vascular tumors with a susceptibility to arise anywhere in the human body. We present a case of a 68-year-old female with primary omental hemangiopericytoma and a two-time recurrence managed with surgery and close follow-up. The first recurrence was at 52 months and the second at 37 months following the prior presentation. No adjuvant chemotherapy or radiation therapy was administered. Given the widespread nature of the cell of origin, routine follow-up postoperatively with interval imaging in order to detect recurrences is imperative. Pathologic tumor characteristics may determine potential for recurrence and may also assist in determining whether adjuvant treatment modalities should be included in the management plan. Review of the English literature reveals a total of 24 cases of omental hemangiopericytomas inclusive of the current report.

Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature

Hemangiopericytoma is a rare primary tumor originating from Zimmerman's pericytes, with significant metastatic potential. Hepatic metastatic disease requires an aggressive approach by a multidisciplinary team of dedicated oncology specialists, to prolong survival in selected patients. We report on a patient with recurrent hepatic metastases of grade II intracranial hemangiopericytoma 5 years after initial treatment, managed by a stepwise combination of liver resection, radiofrequency ablation, and transarterial embolization. Although metastatic disease implies hematogenous dissemination, long-term survival after liver resection has been reported and major hepatectomies are justified in patients with adequate local control. Liver resections combined with transarterial embolization are highly recommended, due to hypervascularity of the tumor.

Comparing central nervous system (CNS) and extra-CNS hemangiopericytomas in the Surveillance, Epidemiology, and End Results program: analysis of 655 patients and review of current literature

BACKGROUND

Hemangiopericytomas (HPCs) are rare tumors in the central nervous system (CNS) and in extra-CNS sites. The authors of this report used the Surveillance, Epidemiology, and End Results (SEER) Program to study prognostic factors in patients with HPC.

METHODS

The SEER database was analyzed for patients who were diagnosed with HPC tumors from 1973 to 2007. Patients were stratified into CNS and extra-CNS groups. Univariate and multivariate analyses were performed for the overall survival (OS) endpoint using major demographic factors (age, race, and sex) and disease factors (tumor site).

RESULTS

In total, 655 patients with HPC were stratified into a CNS group (n = 199) and an extra-CNS group (n = 456). The patients with extra-CNS HPC were statistically older (mean age, 53 years vs 49 years; P = .008) and were more likely to have larger tumors (median greatest dimension, 7.0 cm vs 5.2 cm; P < .001). Patients who had CNS tumors had better OS and cause-specific survival (CSS) compared with patients who had extra-CNS tumors (P < .001 for both). Negative predictors of OS on multivariate analysis included extra-CNS tumor site (hazard ratio [HR], 1.6; P = .005) and older age (ages 40-59 years: HR, 2.08; P = .032; ages 60-79 years: HR, 3.9; P < .001; aged ≥80 years: HR, 7.7; P < .001).

CONCLUSIONS

The current analysis demonstrated that patients with extra-CNS HPCs had worse OS and CSS than patients with CNS HPCs.

Primary haemangiopericytoma in the pelvic cavity of a dog

A 9-year-old female Yorkshire terrier with lameness of the hind leg was examined at the local animal hospital in Gwangju, Republic of Korea on March, 2004. The radiological findings revealed a mass between the urinary bladder and cervix of the uterus. The encapsulated pelvic mass, measuring 4.0 x 3.0 x 2.5 cm was surgically removed. Grossly, the mass was white and firm and microscopically showed a perivascular whorled pattern of spindle cells. By immunohistochemistry, tumour cells tested positive for vimentin and alpha-smooth muscle actin, and negative for desmin, S-100, lysozyme and cytokeratin. The tumour was diagnosed both histologically and immunohistochemically as a haemangiopericytoma. There were no signs of recurrence within 12 months after surgery. This is the first case report of a haemangiopericytoma in the pelvic cavity of a dog.