Primary malignant haemangiopericytoma of the larynx (a case report with autopsy)

Haemangiopericytoma of the larynx

Haemangiopericytoma is an uncommon vascular tumour which has rarely been recorded in the larynx. The diagnostic and histopathological difficulties are discussed. A total laryngectomy was performed because of the size and site of the tumour, the associated risk of local recurrence and the high metastatic rate.

Hemangiopericytoma of the sphenoid sinus

A 51-year-old woman complained of intermittent nasal obstruction and rhinorrhea. Sinus roentgenograms and polytomograms revealed a small mucocele of the right sphenoid sinus. There was no encroachment of the orbital apex or intracranial contents. The mucocele was marsupialized via an external ethmoidectomy, and the scant tissue present inside the sinus was examined histologically. The pathologic diagnosis was hemangiopericytoma. The small tumor had apparently originated at the sinus ostium, thus creating the mucocele. Several months postoperatively, a small, vascular tumor nodule was noted in the incision. No recurrence was evident intranasally. A course of 5,040 rads of external beam radiation therapy was given to the right ethmoid labyrinth and right sphenoid. Since completing her radiation therapy, there has been no recurrence. This case is of interest because the tumor occurred as a mucocele of the sphenoid sinus.

The pathology of head and neck tumors: vasoformative tumors, part 9B

There are three principal malignant vasoformative tumors that can be found in the head and neck--hemangiopericytoma, angiosarcoma, and Kaposi's sarcoma. All are uncommon and provide challenges for the pathologist and the therapist both. The histogenesis of each tumor is different. Kaposi's sarcoma has many features which suggest that it is an altered immune-response disease. Angiosarcoma is a malignancy of endothelium. Hemangiopericytoma is a tumor whose cell of origin is considered to be the perithelial pericyte. The general prognosis for patients with Kaposi's sarcoma is good. The biologic course of a hemangiopericytoma is variable and unpredictable, but there appears to be a site dependency. Angiosarcomas, particularly high grade lesions, are resistant to therapy.

Haemangiopericytoma in otolaryngology

Haemangiopericytoma is a rare vascular tumour with variable pathological behaviour. It arises from the proliferation of special cells called 'pericytes' which are found outside the blood capillaries. There is no specific predilection for any site in the body. Clinically and histologically, it can be benign or malignant, but this differentiation sometimes becomes rather a hard task for the pathologist. Wide surgical excision is the treatment of choice. Radiotherapy and chemotherapy can be valuable adjuncts. Only fourteen cases of nasal haemangiopericytoma have been reported in the literature and these are individually set out in Table I. Another case is reported in this paper, with a review of all the tumours in the field of Otorhinolaryngology since 1942.