1
|
Safi SE, Godfrain J, Rooijakkers H, Collignon F. Complete Resection of a Torcular Herophili Hemangiopericytoma without Sinus Reconstruction: A Case Report and Review of the Literature. Case Rep Surg 2023; 2023:2349363. [PMID: 37711282 PMCID: PMC10499534 DOI: 10.1155/2023/2349363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
A 78-year-old woman presented to the emergency department with mild headaches and a sudden onset of blurred vision. Computerized tomography scan and magnetic resonance imaging showed what was described at first as a meningioma invading and occluding the torcular Herophili, the posterior third of the superior sagittal sinus and the proximal part of the right transverse sinus. Gross total resection of the tumor was performed without reconstructing dural sinuses. The patient was discharged home without new neurological deficit. Histopathology was in favor of a hemangiopericytoma Grade II World Health Organization (WHO). Total body positron emission tomography [18F]fluorodeoxyglucose found no secondary location. Radiotherapy was planned post-operatively.
Collapse
Affiliation(s)
- Salah-Edine Safi
- Centre Hospitalier Interrégional Edith Cavell, Brussels, Belgium
| | - Julie Godfrain
- Centre Hospitalier Interrégional Edith Cavell, Brussels, Belgium
| | | | | |
Collapse
|
2
|
Yu Y, Hu Y, Lv L, Chen C, Yin S, Jiang S, Zhou P. Clinical outcomes in central nervous system solitary-fibrous tumor/hemangiopericytoma: a STROBE-compliant single-center analysis. World J Surg Oncol 2022; 20:149. [PMID: 35538540 PMCID: PMC9088104 DOI: 10.1186/s12957-022-02619-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/29/2022] [Indexed: 02/08/2023] Open
Abstract
Background Solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) are rare mesenchymal tumors in the central nervous system with a high tendency to relapse, having a significant impact on quality of life (QoL). Due to the rarity of intracranial SFT/HPC, the prognostic factors and optimal treatment remain to be elucidated. Meanwhile, quality of life in patients with intracranial SFT/HPC is seldomly concerned. Thus, we aim to survey about the quality of life and underline some aspects demanding concern in intracranial SFT/HPC treatment through summarizing our case series in recent ten years. Methods Patients with intracranial SFT/HPC who underwent surgical resection from January 2009 to June 2019 were included in the study. Clinical features, such as age, gender, and resection extent, were collected. The EuroQol Five Dimensions Questionnaire (EQ-5D) was used to assess the patients’ quality of life (QoL). Prognosis factors related to progression-free survival (PFS) and overall survival (OS) were also evaluated. Results Thirty-six patients with a mean follow-up period of 61.6 months (range 13–123 months) were included in this study. Sixteen (44.4%) patients achieved gross total resection (GTR). Fourteen patients (38.9%) with tumor progression experienced adjuvant radiotherapy (11.1%) or Gamma Knife surgery (GKS, 27.8%). According to the 2016 WHO classification, there were 6 (16.7%) grade I SFT/HPC, 11 (30.5%) grade II SFT/HPC, and 19 (52.8%) grade III SFT/HPC. The PFS and OS were 29 months (range 4–96 months) and 38 months (range 4–125 months). The median EQ5D-3 L tariff with or without progression was 0.617 (95% CI 0.470–0.756) and 0.939 (95% CI 0.772–0.977) respectively. Gross total resection (GTR, p = 0.024) and grade I SFT/HPC (p = 0.017) were significantly associated with longer PFS. In multivariate analysis, GTR (HR 0.378, 95% CI 0.154–0.927) and adjuvant therapy (HR 0.336, 95% CI 0.118–0.956) result in significantly longer PFS in patients with SFT/HPC. Conclusions Patients underwent GTR and adjuvant therapy had longer PFS. Similarly, patients with lower WHO grade had relatively longer PFS. Therefore, GTR is advocated for the treatment of SFT/HPC. And adjuvant therapy such as GKS could be an alternative treatment for patients who underwent STR or with tumor progression. Further, the QoL decreased in patients with tumor progression and metastasis, and more attention is demanded to the QoL of intracranial SFT/HPC patients.
Collapse
Affiliation(s)
- Yang Yu
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Yu Hu
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Liang Lv
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Cheng Chen
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Senlin Yin
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Shu Jiang
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Peizhi Zhou
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
| |
Collapse
|
3
|
Assi T, Samaha E, Nassereddine H. Long-term extracranial metastatic relapse of an intraventricular solitary fibrous tumor: a case report. Anticancer Drugs 2022; 33:e764-e768. [PMID: 34407040 DOI: 10.1097/cad.0000000000001182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Solitary fibrous tumors (SFTs), an uncommon subtype of soft tissue sarcomas mesenchymal, are frequently diagnosed in the intra-thoracic region. Distant metastasis is detected in 10-40% of SFT patients with a predilection site to the lungs; nevertheless, these can occur rarely in the liver, brain, and bones. This entity was also reported in the abdomen, trunk, head, and neck, extremities but also, in the central nervous system (CNS). In the latter form of SFTs, the meninges were mostly affected while only a few cases were reported in the intraventricular and intraparenchymal region with distinct clinical and behavioral characteristics. In this article, we report the rare case of a relapsing intraventricular SFT with secondary extra-cranial metastases to the bones and soft tissues after 11 years of initial diagnosis, with focus on the available data in the literature on CNS SFTs.
Collapse
Affiliation(s)
- Tarek Assi
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | | | - Hussein Nassereddine
- Department of pathology, Hotel-Dieu de France, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon, France
| |
Collapse
|
4
|
Olmsted ZT, Tabor J, Doron O, Hosseini H, Schneider D, Green R, Wahl SJ, Sciubba DM, D'Amico RS. Intradural Extramedullary Solitary Fibrous Tumor of the Thoracic Spinal Cord. Cureus 2021; 13:e18613. [PMID: 34765368 PMCID: PMC8572645 DOI: 10.7759/cureus.18613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 01/04/2023] Open
Abstract
Solitary fibrous tumors (SFTs) are rare soft tissue neoplasms that can impact the central nervous system (CNS). SFTs comprise <1% of all primary CNS tumors. Here, we describe a rare case of intradural, extramedullary SFT arising within the thoracic spine that was treated with surgical resection. Histological features were evaluated and revealed a highly cellular tumor with positive expression of BCL2, CD34, CD99, and STAT6 proteins that are consistent with a diagnosis of SFT. We discuss the use of surgical intervention for long-term disease control of spinal SFT and evaluate the role of postoperative radiation therapy in management strategies. Lastly, we review the literature reports of intradural, extramedullary SFTs in the thoracic spine. The importance of molecular characterization by histopathology to properly determine diagnosis and prognosis is emphasized.
Collapse
Affiliation(s)
| | - Joanna Tabor
- Neurological Surgery, Northwell Health, New York, USA
| | - Omer Doron
- Neurological Surgery, Northwell Health, New York, USA
| | - Hossein Hosseini
- Pathology and Laboratory Medicine, Northwell Health, New York, USA
| | | | - Ross Green
- Neurological Surgery, Lenox Hill Hospital, New York, USA
| | - Samuel J Wahl
- Pathology and Laboratory Medicine, Northwell Health, New York, USA
| | | | | |
Collapse
|
5
|
Tobias S, Jahshan S, Grober Y, Soustiel JF. Skull base hemangiopericytomas. Acta Neurol Belg 2021; 122:1537-1545. [PMID: 34595730 DOI: 10.1007/s13760-021-01812-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To retrospectively evaluate the clinical outcome of six patients with skull base hemangiopericytomas (HPCs) and that of a cohort of 37 similar patients identified by a systematic review of the literature. METHODS The series constitutes of three men and three women with newly diagnosed skull base HPC who underwent multimodal treatment including surgery, external beam radiotherapy (EBRT) and pre-operative embolization. Furthermore, a systematic review off the literature identified 37 reports of primarily intracranial skull base HPCs. RESULTS Four patients had a gross total resection (GTR) and two patients had a near total resection. Five patients were referred for adjuvant EBRT with a survival ranging from 15 to 47 months. All patients had an excellent outcome and resumed their previous activities. Literature review identified 37 additional patients with skull base HPC. Altogether, tumors were unevenly distributed above and below tentorium. GTR was achieved in half the patients, and 72.1% were referred to EBRT. Out of 37 reported patients in the literature, survival longer than 1 year was described in only 24. Within the combined cohort including the present series, survival was 83.6 months. CONCLUSIONS The present series shows that a radical resection of HPC can be achieved under the difficult anatomical conditions of skull base surgery. Pre-operative arterial embolization may be instrumental to maintain a clear visual field and prevent excessive blood loss. Finally, the results of the present cohort suggest that EBRT may be useful for local growth control, as an effective palliative measure for skull base HPCs.
Collapse
Affiliation(s)
- Samuel Tobias
- Department of Neurosurgery, Galilee Medical Center, Naharia and The Azrieli Faculty of Medicine, Bar Ilan University, POB 21, 2210001, Zafed, Naharia, Israel
| | - Shady Jahshan
- Department of Neurosurgery, Galilee Medical Center, Naharia and The Azrieli Faculty of Medicine, Bar Ilan University, POB 21, 2210001, Zafed, Naharia, Israel
| | - Yuval Grober
- Department of Neurosurgery, Galilee Medical Center, Naharia and The Azrieli Faculty of Medicine, Bar Ilan University, POB 21, 2210001, Zafed, Naharia, Israel
| | - Jean F Soustiel
- Department of Neurosurgery, Galilee Medical Center, Naharia and The Azrieli Faculty of Medicine, Bar Ilan University, POB 21, 2210001, Zafed, Naharia, Israel.
| |
Collapse
|
6
|
Haas RL, Walraven I, Lecointe-Artzner E, van Houdt WJ, Scholten AN, Strauss D, Schrage Y, Hayes AJ, Raut CP, Fairweather M, Baldini EH, Gronchi A, De Rosa L, Griffin AM, Ferguson PC, Wunder J, van de Sande MAJ, Krol ADG, Skoczylas J, Brandsma D, Doglietto F, Sangalli C, Stacchiotti S. Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy? Acta Oncol 2021; 60:35-41. [PMID: 32988268 DOI: 10.1080/0284186x.2020.1826574] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION A meningeal solitary fibrous tumor (SFT), also called hemangiopericytoma, is a rare mesenchymal malignancy. Due to anatomic constrains, even after macroscopic complete surgery with curative intent, the local relapse risk is still relatively high, thus increasing the risk of dedifferentiation and metastatic spread. This study aims to better define the role of postoperative radiotherapy (RT) in meningeal SFTs. PATIENTS AND METHODS A retrospective study was performed across seven sarcoma centers. Clinical information was retrieved from all adult patients with meningeal primary localized SFT treated between 1990 and 2018 with surgery alone (S) compared to those that also received postoperative RT (S + RT). Differences in treatment characteristics between subgroups were tested using independent samples t-test for continuous variables and chi-square tests for proportions. Local control (LC) and overall survival (OS) rates were calculated as time from start of treatment until progression or death from any cause. LC and OS in groups receiving S or S + RT were compared using Kaplan-Meier survival curves. RESULTS Among a total of 48 patients, 7 (15%) underwent S and 41 (85%) underwent S + RT. Median FU was 65 months. LC was significantly associated with treatment. LC after S at 60 months was 60% versus 90% after S + RT (p = 0.052). Furthermore, R1 resection status was significantly associated with worse LC (HR 4.08, p = 0.038). OS was predominantly associated with the mitotic count (HR 3.10, p = 0.011). CONCLUSION This retrospective study, investigating postoperative RT in primary localized meningeal SFT patients, suggests that combining RT to surgery in the management of this patient population may reduce the risk for local failures.
Collapse
Affiliation(s)
- R. L. Haas
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - I. Walraven
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - W. J. van Houdt
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A. N. Scholten
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D. Strauss
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
| | - Y. Schrage
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
- Department of Surgical Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - A. J. Hayes
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
| | - C. P. Raut
- Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - M. Fairweather
- Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - E. H. Baldini
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - A. Gronchi
- Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L. De Rosa
- Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A. M. Griffin
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - P. C. Ferguson
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - J. Wunder
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - M. A. J. van de Sande
- Department of Orthopedic Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - A. D. G. Krol
- Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - J. Skoczylas
- Department of Surgical Oncology, The Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland
| | - D. Brandsma
- Department of Neuro-Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F. Doglietto
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - C. Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S. Stacchiotti
- Adult Mesenchymal and Rare Tumor Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|