A Case of Congenital Maxillary Hemangiopericytoma: A Case Report

Case report: neonatal giant forehead hemangiopericytoma with a 5-year follow-up

RATIONALE

Hemangiopericytoma (HPC) is a rare pediatric neoplasm with a high risk of bleeding, aggressive growth and high early relapse rates. Surgical excision remains the mainstream treatment, while the functions of chemotherapy and radiotherapy remain controversial. In particular, an infantile giant extracranial HPC located in the forehead has never been reported.

PATIENT CONCERNS

A 3-day-old girl was delivered normally with a giant tumor localized mainly in the right frontal region. The surface of the mass was filled with vascularity.

DIAGNOSIS

According to the results of imaging and pathological examinations, the diagnosis was HPC grade II.

INTERVENTIONS

Gross total resection of the tumor and the invading partial frontal bone followed by skin scalp reconstruction was carried out without any blood transfusion.

OUTCOMES

No recurrence was identified during 5 years of follow-up. And better outcomes can be achieved without adjuvant therapy.

LESSONS

Multimodality imaging and a collaborative multidisciplinary approach are indispensable for the successful surgical management of infantile HPC, especially for giant tumors and their potential risk of life-threatening bleeding. Gross total resection is the optimal option for infantile HPC, and even without adjuvant therapy, it achieves better outcomes.

Haemangiopericytoma of the jaw

Haemangiopericytoma (HPC) is a vascular tumour which originates in the pericytes of vessels and therefore it may occur at any site, but it is very uncommon in the jaw. From January 2000 to December 2011, a retrospective analysis of nine consecutive patients with HPCJ was performed. There were five patients with a primary tumour and four patients with a recurrent tumour. Of the nine patients, eight were male and one female. Their ages ranged from 23 years to 51 years, with a median age of 38 years. The tumours were located in the mandible in six patients and in maxilla in three cases. The median course of disease was 7.6 months (range 2-12 months). All patients underwent surgery. Two patients had postoperative adjuvant radiotherapy, and two cases were given postoperative adjuvant chemotherapy. The median follow-up period was 49 months (10-101 months). One patient suffered from lumbar metastasis, while another case had metastasis at local and multiple distant sites, and eventually died. There was no local recurrence or metastasis in other seven cases. HPCJ are rare and the clinical characteristics are not specific. The first choice of treatment is radical surgery. Adjuvant radiotherapy may be effective to improve the prognosis of HPCJ.

Haemangiopericytoma of the mandible

Haemangiopericytomas (HPCs) found in bony structures are rare sarcomas of vascular origin. Here, we report the case of a 41-year-old female with a HPC originating in the right ramus of the mandible. After tumour staging and biopsy for histological reference the tumour was surgically removed. The surgical technique is described and therapy options of these rare cases are discussed and compared with these cases already documented. To the best of our knowledge, this is the 6th case of mandibular HPC reported in the literature.