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Illuminati G, Pizzardi G, Calio F, Pacilè MA, Carboni F, Palumbo P, Vietri F. Hemangiopericytoma of the spleen. Int J Surg 2015; 15:6-10. [PMID: 25638732 DOI: 10.1016/j.ijsu.2015.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/15/2015] [Accepted: 01/21/2015] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Hemangiopericytoma of the spleen is a very rare tumor, with 14 isolated reports. It was our aim to review our experience and compare it with all the reported cases in an attempt to standardize surgical treatment, adjuvant treatment and follow-up protocol of this infrequent condition. METHODS A consecutive case series study, with a mean follow-up of 44 months. Five patients (mean age, 49 years) underwent simple splenectomy for hemangiopericytoma limited to the spleen followed by adriamycin-based chemotherapy in one patient. RESULTS All the patients are alive and free from disease. CONCLUSIONS For tumors confined to the spleen, simple splenectomy can be considered curative, without any need for further adjuvant treatment. On review of the medical literature, cure can still be achieved with complete resection of recurrences, when feasible, with adjuvant chemotherapy being also indicated. The slow-growing pattern of the tumor suggests a 10-year follow-up.
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Affiliation(s)
- Giulio Illuminati
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy.
| | - Giulia Pizzardi
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Francesco Calio
- The Department of Surgery, Sant'Anna Hospital, Catanzaro, Italy
| | - Maria A Pacilè
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Fabio Carboni
- The Department of Surgery, "Regina Elena" Cancer Institute, Rome, Italy
| | - Piergaspare Palumbo
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Francesco Vietri
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
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Primary epidural hemangiopericytoma in the sacrum: a rare case and literature review. Tumour Biol 2014; 35:11655-8. [DOI: 10.1007/s13277-014-2455-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 11/13/2013] [Indexed: 12/27/2022] Open
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Malign recurrence of primary chest wall hemangiopericytoma in the lung after four years: a case report and review of the literature. Case Rep Oncol Med 2014; 2014:470268. [PMID: 25197592 PMCID: PMC4145366 DOI: 10.1155/2014/470268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/15/2014] [Indexed: 11/21/2022] Open
Abstract
Hemangiopericytoma (HPC) may develop in every site where the endothelial tissue exits and primarily develops in the skeletal-muscular system or the skin. Adult cases of HPC generally exhibit a benign course. 20–30% of the cases may show a malign course. The tumors that show more than four mitoses, a focal area of necrosis, and increased cellularity on a magnification ×10 are considered as malign. In our paper, we presented our case who showed a lung metastasis at the end of 4 years and who developed a pathological fracture of the right humerus at the end of approximately 2 years, because hemangiopericytoma is rarely seen in the chest wall as a primary tumor.
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Dahodwala MQ, Husain Q, Kanumuri VV, Choudhry OJ, Liu JK, Eloy JA. Management of sinonasal hemangiopericytomas: a systematic review. Int Forum Allergy Rhinol 2013; 3:581-7. [PMID: 23389865 DOI: 10.1002/alr.21139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/17/2012] [Accepted: 11/17/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hemangiopericytomas are typically found in soft-tissue, but only rarely found in the sinonasal tract. Sinonasal hemangiopericytomas have been reported mostly through case studies, and optimal treatment is considered surgical excision. Classically, open surgical methods of tumor extirpation have been considered standard of care. With the wider use of endoscopic methods, an updated systematic review in terms of treatment is warranted. METHODS Cases were identified using a MEDLINE and PubMed search. Relevant studies were identified, and data was extracted regarding patient demographics, presenting symptoms, tumor characteristics, treatment, and outcomes. RESULTS A total of 128 cases were collected from 56 articles, consisting of case reports and series. The most common presenting symptoms were epistaxis, nasal obstruction, and facial pain/swelling/pressure. Computed tomography (CT) and X-ray were the most common modes of imaging during diagnosis and operative planning. The tumor often occupied multiple locations in the sinonasal tract at initial presentation. Surgical resection was the mainstay of treatment in 126 of the 128 cases (98.4%), either through open resection or endoscopic techniques. Surgical removal resulted in no recurrence in 79.7% of the cases. The use of endoscopic techniques increased significantly in the past decade. This review found no significant difference in terms of recurrence between endoscopic and open treatment groups, age, gender, and unilocality vs multilocality of tumor. CONCLUSION Surgical management remains the mainstay of treatment for hemangiopericytomas. Endoscopic resection of these lesions has increased over the last few decades and has become a safe, viable, and reasonable alternative to open resection.
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Affiliation(s)
- Mufaddal Q Dahodwala
- Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07103, USA
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Duval M, Hwang E, Kilty SJ. Systematic review of treatment and prognosis of sinonasal hemangiopericytoma. Head Neck 2012; 35:1205-10. [PMID: 22733718 DOI: 10.1002/hed.23074] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2012] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the recurrence rate for open and endoscopic surgery and the clinical prognosis of this sinonasal tumor. METHODS A systematic review of individual cases of sinonasal hemangiopericytoma was performed. A total of 97 articles were included in the study and reviewed to extract the relevant information about each case. RESULTS In all, 194 cases of sinonasal hemangiopericytoma were identified. There were 53 recurrences (27.3%), 6 tumor-related deaths (3.1%), and 4 cases of metastases (2.1%). There was no significant difference between rate of recurrence for endoscopic or open resection (p = .06). Incomplete excision was the most important predictor of recurrence (odds ratio = 11.50, 95% confidence interval 3.76-36.82, p < .001). Radiotherapy may be advantageous in cases of incomplete surgical resection (p = .03). CONCLUSIONS Complete excision is essential to minimize tumor recurrence and radiotherapy may decrease the rate of recurrence in the case of incomplete resection. Current evidence does not suggest that open resection is superior to endoscopic resection.
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Affiliation(s)
- Melanie Duval
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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Thiringer JK, Costantino PD, Houston G. Sinonasal hemangiopericytoma: case report and literature review. Skull Base Surg 2011; 5:185-90. [PMID: 17170946 PMCID: PMC1656489 DOI: 10.1055/s-2008-1058934] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hemangiopericytoma (HPC) is a rare vascular tumor that can arise in any organ system, but occurs most frequently in skeletal muscle. We present a case of a primary sphenoid sinus HPC unusual for its spontaneous remission after biopsy. There have been approximately 55 cases of sinonasal HPC reported in the literature, representing less than 5% of all lesions. In general, HPC behaves aggressively, demonstrating greater than 50% local recurrence and 10% metastatic disease. Although extended surgical resection is traditionally considered the most effective therapy for all HPC, critical literature review does not support this method of treatment for HPC occurring in the paranasal sinuses and skull base. Long-term follow-up indicates that the majority of sinonasal HPC have a benign clinical course regardless of treatment. As a result, we do not recommend extended resection as the initial therapy for sinonasal HPC. Instead, a period of observation coupled with serial MRI or CT scans should be used to detect tumor progression. These indolent tumors should undergo extended resection only after progression has been confirmed. In addition to the case report, a synopsis of the reviewed literature and a summary of treatment recommendations are also presented.
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Ransom ER, Judy KD, Bigelow DC. Concurrent Cochlear Implantation with Resection of Skull Base Hemangiopericytoma following Sudden Deafness in an Only Hearing Ear. Skull Base 2011; 20:279-84. [PMID: 21311622 DOI: 10.1055/s-0030-1247633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 72-year-old man with a known left acoustic neuroma, left-sided deafness, and a recently diagnosed right infratemporal fossa (ITF) hemangiopericytoma, presented with sudden deafness in his right ear. Imaging revealed right-sided skull base extension and a large intracranial tumor component. The patient underwent a frontotemporal crainiotomy with concomitant ITF approach. Complete tumor resection was possible, though invasion of the otic capsule was present. Immediately postresection, a cochlear implant (CI) was performed via a transmastoid approach. Full electrode insertion was achieved and confirmed by visualization through the dehiscent middle fossa floor. Mastoid obliteration was then performed with a free fat graft. Postoperative imaging confirmed complete tumor resection (Simpson grade I) and adequate CI placement. Follow-up magnetic resonance imaging was performed at 6 and 12 months, and no tumor recurrence was seen. Prior to CI activation, the patient was completely deaf bilaterally. At 18-month follow-up, however, excellent hearing was achieved with the right CI (16 of 22 electrodes active), and the patient is now conversational with no obvious deficit. His cognitive function is excellent, corresponding to preoperative status, and he is independent in his activities of daily living. Following adjuvant radiation, our patient remains disease free at 18 months.
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Affiliation(s)
- Evan R Ransom
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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LUMSDEN A, WILSON JA, MCLAREN K, MARAN AGD. Unusual polypoidal tumours of the nasal cavity: a clinicopathological review of 18 cases. Clin Otolaryngol 2009. [DOI: 10.1111/j.1365-2273.1986.tb01989.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mimoun M, Badoual C, Meatchi T, Bonfils P. [Sinonasal hemangiopericytomas]. ACTA ACUST UNITED AC 2008; 125:18-23. [PMID: 18328458 DOI: 10.1016/j.aorl.2007.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 11/14/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to report on the clinical, radiological and histological characteristics of hemangiopericytomas, and to discuss our experience with their treatment. MATERIAL AND METHODS The authors reexamined two recent cases of patients presenting with sinonasal hemangiopericytomas (semiology, CT and MRI results, treatment and follow-up). RESULTS AND DISCUSSION There was substantial variability of hemangiopericytoma presentation depending on location. Hemangiopericytomas of the nose and paranasal sinuses are considered a distinct entity with a good prognosis. Treatment is based on endoscopic sinus surgery. The histological approach requires the use of immunohistochemistry. Recurrences vary in the literature depending on the initial resection quality. Metastases are rare.
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Affiliation(s)
- M Mimoun
- Service d'ORL et de chirurgie cervicofaciale, faculté de médecine René-Descartes, université Paris-V, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Stomeo F, Fois V, Cossu A, Meloni F, Pastore A, Bozzo C. Sinonasal haemangiopericytoma: a case report. Eur Arch Otorhinolaryngol 2004; 261:555-7. [PMID: 14714131 DOI: 10.1007/s00405-003-0726-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2003] [Accepted: 10/31/2003] [Indexed: 10/26/2022]
Abstract
Haemangiopericytoma (HPC) is a rare vascular tumour that is thought to originate from the vascular pericytes of Zimmerman. HPC may arise in any part of the body, and from 15 to 30% of these tumours are found in the head and neck, with a rare involvement of the sinonasal region The main symptoms of nasal HPC, epistaxis and nasal obstruction, are not typical. The final diagnosis is based on the histopathology and immunochemistry, and whether the tumour is benign or malignant is defined on the basis of the clinical history. HPC located in the sinonasal area is generally benign. We report the case of a young woman with a sinonasal mass histologically proven to be haemangiopericytoma. The patient underwent surgical treatment by means of mid-facial degloving after embolisation of the maxillary artery. After a careful 3-year follow-up, the patient is disease free and healthy.
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Affiliation(s)
- Francesco Stomeo
- Department of Otolaryngology and Head and Neck Surgery, Sassari University Medical Centre, Sassari, Italy.
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Thompson LDR, Miettinen M, Wenig BM. Sinonasal-type hemangiopericytoma: a clinicopathologic and immunophenotypic analysis of 104 cases showing perivascular myoid differentiation. Am J Surg Pathol 2003; 27:737-49. [PMID: 12766577 DOI: 10.1097/00000478-200306000-00004] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sinonasal-type hemangiopericytoma is an uncommon upper aerodigestive tract tumor of uncertain cellular differentiation. We report 104 cases of sinonasal-type hemangiopericytoma diagnosed between 1970 and 1995 from the files of the Armed Forces Institute of Pathology. There were 57 females and 47 males ranging in age from 5 to 86 years (mean 62.6 years). The most common clinical presentation was airway obstruction (n = 57) and/or epistaxis (n = 54), with symptoms averaging 10 months in duration. The tumors involved the nasal cavity alone (n = 47) or also a paranasal sinus (n = 26), were polypoid, and measured an average of 3.1 cm. Histologically, the tumors were submucosal and unencapsulated and showed a diffuse growth with fascicular (n = 37) to solid (n = 50) to focally whorled (n = 7) patterns. The tumor cells were uniform in appearance with minimal pleomorphism and had spindle-shaped (n = 82) to round/oval (n = 18) nuclei with vesicular to hyperchromatic chromatin and eosinophilic to amphophilic to clear-appearing cytoplasm with indistinct cell borders. Multinucleated (tumor) giant cells were identified in a minority of cases (n = 5). Mitotic figures were inconspicuous and necrosis was absent. The tumors were richly vascularized, including staghorn-appearing vessels that characteristically had prominent perivascular hyalinization (n = 92). An associated inflammatory cell infiltrate that included mast cells and eosinophils was noted in the majority of cases (n = 87). The immunohistochemical profile included reactivity with vimentin (98%), smooth muscle actin (92%), muscle specific actin (77%), factor XIIIa (78%), and laminin (52%). Surgery was the treatment of choice for all of the patients; adjunctive radiotherapy was given to four patients. Recurrences developed in 18 patients within 1-12 years from diagnosis. Ninety-seven patients were either alive (n = 51, mean 16.5 years) or dead (n = 46, mean 9.6 years) but free of disease. Four patients had disease at the last follow-up: three died with disease (mean 3.6 years) and one patient is alive with disease (28.3 years). Recurrent tumor (17.8%) can be managed by additional surgery. The majority of sinonasal-type hemangiopericytomas behave in a benign manner with excellent long-term prognosis (88% raw 5-year survival) following surgery alone. Sinonasal-type hemangiopericytomas have a characteristic light microscopic appearance with an immunophenotypic profile resembling that of glomus tumors.
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Affiliation(s)
- Lester D R Thompson
- Department of Endocrine, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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13
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Abstract
Although unusual, hemangiopericytoma (HPC) can be considered benign or malignant depending on histologic features. In some cases, malignant HPC can behave as high-grade sarcomas. When HPC is deemed malignant, radical surgical excision is the treatment of choice. Adjuvant chemotherapy and radiation therapy offer limited success in patients with this malignancy. This article details a case study of a man with metastatic malignant HPC that spanned 25 months and three major cancer centers. Throughout the case study, chemotherapy, radiation therapy, and an experimental agent were employed to attempt to achieve control of the aggressive disease. Often, patients with HPC need a multidisciplinary approach to their care that requires involvement of nutritional and social services, behavioral medicine, and home or hospice care as appropriate. A better general understanding of this disease process is needed to meet the needs of patients with malignant HPC.
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Watanabe K, Saito A, Suzuki M, Yamanobe S, Suzuki T. True hemangiopericytoma of the nasal cavity. Arch Pathol Lab Med 2001; 125:686-90. [PMID: 11300947 DOI: 10.5858/2001-125-0686-thotnc] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Two cases of nasal tumors with pericytic myoid differentiation are reported. The tumors occurred in a 77-year-old woman and a 60-year-old man as polypoid lesions covered by normal mucosa. Histologically, the tumors were composed of uniform short spindle or stellate cells with indistinct cell borders arranged in narrow and short fascicles. Numerous blood vessels of various sizes were common in both cases. The tumor cells of both cases stained intensely with anti-vimentin and anti-actin antibodies, but not with anti-desmin, CD34, or anti-high-molecular-weight caldesmon antibodies. Ultrastructural examination revealed well-developed actin thin filaments with dense bodies, subplasmalemmal plaques, intercellular junctions, and irregular discontinuous basement membranes. These histopathologic features suggest true pericytic differentiation of the tumors (true hemangiopericytoma), unlike soft tissue-type hemangiopericytoma. Generally, sinonasal hemangiopericytomas are subdivided into soft tissue-type hemangiopericytomas and true hemangiopericytomas identical to the cases presented here. Soft tissue-type hemangiopericytomas are frequently highly aggressive, whereas true hemangiopericytomas show localized benign behavior. Sinonasal true hemangiopericytomas should be strictly differentiated from soft tissue-type hemangiopericytomas.
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Affiliation(s)
- K Watanabe
- Pathology Division, Fukushima Medical University School of Medicine Hospital, 1 Hikariga-oka, Fukushima City, 960-1295, Japan.
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Abstract
PURPOSE To report a series of patients with hemangiopericytoma (HP) of the head and neck, to review pathological features of these tumors, and to discuss management options. MATERIALS AND METHODS A retrospective review of the medical records at the University of California, Los Angeles (UCLA) Medical Center in Los Angeles, CA, was done in order to identify those patients with primary HP of the head and neck, including soft tissue and mucosal sites. RESULTS Ten patients with HP of the head and neck were identified. There was an equal sex distribution and an average age of 36 (range 10-65). Seven of the tumors arose from soft tissue sites in the head and neck, and the remaining 3 arose from the mucosa. All patients underwent wide excision of the primary lesion with a local recurrence rate of 40%. Thirty percent of patients developed metastatic lung disease 0 to 8 years after initial diagnosis. Each patient who developed metastatic disease had abundant mitoses on pathological review compared with rare or absent mitoses in the lesions that took a more benign course. CONCLUSIONS Pathological appearance of resected HP is predictive of later metastatic potential. Long-term follow-up is necessary in patients even after radical resection because recurrence or metastasis may be delayed by many years.
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Affiliation(s)
- K R Billings
- Department of Otolaryngology, Southwestern Medical Center, Dallas, TX, USA
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Karasen RM, Sutbeyaz Y, Gundogdu C, Eren S, Sirin S. Haemangiopericytoma of the middle ear with benign histological features. J Laryngol Otol 1999; 113:911-3. [PMID: 10664707 DOI: 10.1017/s0022215100145566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Haemangiopericytoma is a rare vascular tumour, particularly in the head and neck region. We described the first case of haemangiopericytoma arising from the middle ear in 1995. The present case is the second example of a primary middle-ear haemangiopericytoma with benign histological features. Clinical photography, computed tomography (CT) and magnetic resonance imaging (MRI) scans and histological photographs depict the findings.
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Affiliation(s)
- R M Karasen
- Department of Otolaryngology, Ataturk University, School of Medicine, Erzurum, Turkey.
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Marianowski R, Wassef M, Herman P, Huy PT. Nasal haemangiopericytoma: report of two cases with literature review. J Laryngol Otol 1999; 113:199-206. [PMID: 10435124 DOI: 10.1017/s0022215100143580] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Haemangiopericytoma (HPC) is a rare vascular tumour produced by proliferation of pericytes. One hundred and thirty-three cases of HPC have been reported in the nose and the paranasal sinuses. We present two more cases. Wide surgical excision via lateral rhinotomy, midfacial degloving, or endonasal removal is the treatment of choice. Radiotherapy has been used post-operatively in cases of incomplete removal. Life-long follow-up is required to evaluate local recurrence and late metastases.
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Affiliation(s)
- R Marianowski
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Lariboisière, Paris, France
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Spitz FR, Bouvet M, Pisters PW, Pollock RE, Feig BW. Hemangiopericytoma: a 20-year single-institution experience. Ann Surg Oncol 1998; 5:350-5. [PMID: 9641457 DOI: 10.1007/bf02303499] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hemangiopericytoma is an uncommon soft tissue sarcoma. We sought to evaluate the long-term outcome of a consecutively treated patient cohort with hemangiopericytoma. METHODS The study involved 36 adult patients (older than 16 years) with hemangiopericytoma treated at The University of Texas M. D. Anderson Cancer Center between July 1975 and July 1995. Data on clinicopathologic parameters, surgical treatment, adjuvant therapy, disease recurrence, and survival were obtained from a review of medical records. RESULTS The median follow-up was 57 months. Twenty-eight patients (78%) underwent complete and potentially curative resection of their primary disease. Of the nine patients (32%) who had local recurrences, four (57%) had epidural tumors and three (43%) had retroperitoneal tumors, but none had extremity tumors. Extremity tumors were associated with a significantly prolonged local recurrence-free survival compared to tumors at nonextremity anatomic sites (P <.05). Ten patients had recurrences at distant sites. Of the 13 patients who experienced any form of disease recurrence, four had recurrences after a disease-free interval of more than 5 years. The 5-year actuarial survival rate for the entire group of 36 patients was 71%. Noncurative surgical treatment (P=.007) and development of distant metastatic disease (P=.013) were associated with shortened survival. CONCLUSION Extended survival is common in hemangiopericytoma patients treated with curative intent. However, local and distant recurrences may occur after a prolonged disease-free interval, emphasizing the need for long-term follow-up. Retroperitoneal and meningeal tumors were associated with higher local recurrence rates; therefore, adjuvant therapies should be considered and evaluated for tumors at these sites.
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Affiliation(s)
- F R Spitz
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Kothari PS, Murphy M, Howells GL, Williams DM. Hemangiopericytoma: a report of two cases arising on the lip. Br J Oral Maxillofac Surg 1996; 34:454-6. [PMID: 8909742 DOI: 10.1016/s0266-4356(96)90107-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Hemangiopericytoma is a rare tumour of pericytes; represents 1% of all vasoformative tumours and 15-25% of those which occur in the head and neck. We present two cases of hemangiopericytoma occurring on the lower lip and report the use of cryosurgery to treat the most recent case.
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Cross DL, Mixon C. Temporal bone Hemangiopericytoma. Otolaryngol Head Neck Surg 1996; 114:631. [PMID: 8643276 DOI: 10.1016/s0194-59989670258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- D L Cross
- Department of Otolaryngology, Baptist Hospital, Nashville, TN 32703, USA
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Catalano PJ, Brandwein M, Shah DK, Urken ML, Lawson W, Biller HF. Sinonasal hemangiopericytomas: a clinicopathologic and immunohistochemical study of seven cases. Head Neck 1996; 18:42-53. [PMID: 8774921 DOI: 10.1002/(sici)1097-0347(199601/02)18:1<42::aid-hed6>3.0.co;2-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Sinonasal hemangiopericytoma (SNHPC) is a rare lesion usually of low-grade malignant potential. Aggressive and metastatic cases are uncommon, and experience using adjuvant therapy on these cases has been limited. Tumor-induced osteomalacia has a very rare association with SNHPC. Further, the diagnosis of SNHPC remains one of histologic-pattern recognition. Traditionally, immunohistochemistry has aided in excluding other diagnoses; only vimentin has been consistently expressed by the tumor spindle cells of HPC. Recent studies have shown that Factor XIIIa is also expressed by HPC, (as well as tumors of fibrohistiocytic differentiation) and hence may be yet another helpful positive marker in establishing an immunohistochemical profile. METHODS We identified 7 patients at this institution with SNHPC from 1990 to 1994. Immunohistochemistry was performed on seven formalin-fixed paraffin-embedded tumors utilizing antibodies to factor XIIIa as well as antibodies to vimentin, factor VIII, muscle-specific antigen, cytokeratin, and S-100. RESULTS All 7 patients were initially seen with nasal obstruction or epistaxis and underwent surgical resection. The period of follow-up was from 3 months to 14 years (mean 54 months) for 7 patients. Three patients had recurrent disease after 3, 5, and 10 years. The first 2 were known to have been originally treated by polypectomy. One patient required adjuvant radiotherapy for metastatic disease and local extension. One patient was initially seen with tumor-induced osteomalacia which dramatically improved following resection of the lesion. The immunohistochemical profile revealed strong expression of vimentin in 7/7 cases, and of factor XIIIa in 4/7 cases; tumor cells did not express the other markers studied. CONCLUSIONS Adequate surgical resection with negative margins appears to be the appropriate therapy for SNHPC. Our 1 case associated with tumor-induced osteomalacia was reversible after surgical excision of the tumor. The immunohistochemical results suggest that the pattern of vimentin and factor XIIIa positivity, as well as lack of expression of other markers, is consistent with the diagnosis of HPC, which still remains in the domain of histopathology.
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Affiliation(s)
- P J Catalano
- Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029, USA
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23
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Günhan O, Yildiz FR, Selmanpakoğlu N. Mandibular hemangiopericytoma: report of a case and review of the literature. J Oral Maxillofac Surg 1995; 53:704-7. [PMID: 7776057 DOI: 10.1016/0278-2391(95)90177-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- O Günhan
- Gülhane Military Medical Academy, Ankara, Turkey
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24
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Affiliation(s)
- G Lee
- Dental Department, Veterans General Hospital, Taipei, Taiwan, Republic of China
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25
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Nasal hemangiopericytoma. Indian J Otolaryngol Head Neck Surg 1991. [DOI: 10.1007/bf02994111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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26
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Abstract
Haemangiopericytoma is an uncommon vascular tumour with a widespread distribution. Although meningeal involvement is well recognized, only a few sporadic cases of temporal bone lesions have been documented, all with doubtful sites of origin. Late presentation together with the restrictive anatomy of this region often precludes its effective removal and even minimal residual disease may progress rapidly. A series of three such patients are presented in order to discuss the natural history, histological features and treatment of this disease.
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Affiliation(s)
- A R Birzgalis
- University Department of Otolaryngology, Manchester Royal Infirmary
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27
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Abdel-Fattah HM, Adams GL, Wick MR. Hemangiopericytoma of the maxillary sinus and skull base. Head Neck 1990; 12:77-83. [PMID: 2404907 DOI: 10.1002/hed.2880120112] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Since 1949, only 52 cases of hemangiopericytoma (HPC) of the nose and paranasal sinuses have been reported in the literature. Of the latter, only 2 originated from the maxillary sinus. This article reports 2 new cases. One arose in the maxillary sinus and involved the pterygopalatine fossa, skull base, and infratemporal fossa. The second tumor was located in the sphenoethmoidal recess. A new combination of techniques for resection of hemangiopericytoma of the skull base is described. Prognostic criteria for such tumors are reviewed, in conjunction with histological diagnosis.
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Affiliation(s)
- H M Abdel-Fattah
- Department of Otolaryngology, University of Minnesota, Minneapolis
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28
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Abstract
Hemangiopericytoma is an uncommon vascular tumour. Of the 26 intranasal hemangiopericytomas reported in the English literature only two paediatric cases have been noted. A benign course is more common in the nose and paranasal sinuses. A pre-operative diagnosis being not possible, definitive treatment cannot be preplanned. Wide surgical excision by a lateral rhinotomy approach is still the treatment of choice. The appropriate investigations and treatment line followed are described. A lifelong followup is mandatory.
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Affiliation(s)
- V Anand
- Department of ENT, Kasturba Medical College and Hospital, Manipal, India
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29
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O'Reilly BJ, Ryan J, Reynard J, Chevretton E. Malignant fibrous histiocytoma of the nasopharynx. J Laryngol Otol 1989; 103:1076-9. [PMID: 2558140 DOI: 10.1017/s0022215100111041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Malignant Fibrous Histiocytomas (MFH) are uncommon in the head and neck and extremely rare in the nasopharynx. We report a case of MFH arising in the nasopharynx and describe its diagnosis and management. The literature is reviewed and the likely origins of the tumour and its behaviour are discussed.
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Affiliation(s)
- B J O'Reilly
- Department of Histopathology, Chestnut Villa, Severalls Hospital, Colchester, Essex
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30
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Vyas N, Agarwal KK. Haemangiopericytoma of the nasal cavity. Indian J Otolaryngol Head Neck Surg 1989. [DOI: 10.1007/bf02994037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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31
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Bradley PJ, Narula A, Harvey L, Holland I, Morgan DA, MacLennan K. Haemangiopericytoma of the larynx. J Laryngol Otol 1989; 103:234-8. [PMID: 2926278 DOI: 10.1017/s0022215100108576] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
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.
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Affiliation(s)
- P J Bradley
- Combined Head and Neck Oncology Clinic, University Hospital, Queens Medical Centre, Nottingham, England
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32
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Abstract
Haemangiopericytoma is a rare vascular tumour originating from pericytes which are cells surrounding the capillaries. Only 23 cases of haemangiopericytoma arising from the nose and sinuses have been reported in the literature, of which three are from the nasal septum. We are pleased to report one more case.
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Affiliation(s)
- S Al-Khalifa
- Department of Ear, Nose & Throat, Bahrain Defence Force Hospital
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33
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Pagliaro G, Poli P, Ralza G, Grandi G. Haemangiopericytoma of the submandibular gland (a case report). J Laryngol Otol 1988; 102:97-9. [PMID: 3343576 DOI: 10.1017/s0022215100104116] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
SummaryA case of haemangiopericytoma of the submandibular gland is reported. The clinical, surgical and histological features are described.
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Affiliation(s)
- G Pagliaro
- ENT Department, University of Trieste, Italy
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34
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Jha N, McNeese M, Barkley HT, Kong J. Does radiotherapy have a role in hemangiopericytoma management? Report of 14 new cases and a review of the literature. Int J Radiat Oncol Biol Phys 1987; 13:1399-402. [PMID: 3305450 DOI: 10.1016/0360-3016(87)90236-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
From 1948 to 1984, 14 adult patients received radiation therapy as a part of their treatment for hemangiopericytoma at the University of Texas M.D. Anderson Hospital and Tumor Institute at Houston. In addition to radiation therapy 11 patients were treated with surgery, with or without chemotherapy--5 as primary management and 6 after recurrence following surgical excision. Although 9 of these 11 patients had macroscopic and 1 had definite microscopic disease at the time of irradiation, none suffered local recurrence and 9 have survived from 3.5 years to 20 years free of disease. Two of the 11 patients died of distant metastases. Two patients completed treatment for palliation and 1 of them survived for 2 years after treatment. The results suggest that postoperative radiation therapy should be considered as an integral part of the primary treatment of hemangiopericytoma.
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35
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Abstract
The uncertain course and rarity of haemangiopericytoma in the nose and paranasal sinuses has interested both pathologists and clinicians. This tumour arises from proliferation of pericytes which invest capillary endothelium. A benign course is more common in the nose and paranasal sinuses. The first nasal haemangiopericytoma was reported by Stout in 1949. Since then only twenty cases have been reported in the literature. We present three further cases.
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36
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Robb PJ, Singh S, Hartley RB, Shaheen OH. Malignant hemangiopericytoma of the parapharyngeal space. HEAD & NECK SURGERY 1987; 9:179-83. [PMID: 3623949 DOI: 10.1002/hed.2890090309] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Hemangiopericytoma is a rare vascular neoplasm, occasionally occurring in the head and neck region. Diagnosis is made histologically, but even then, it is difficult to predict the behavior of the tumor in an individual patient. The patient described in this report presented with symptoms of parapharyngeal compression due to such a tumor. It is believed that malignant hemangiopericytoma has not been previously reported in this site.
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37
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38
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Lumsden A, Wilson JA, McLaren K, Maran AG. Unusual polypoidal tumours of the nasal cavity: a clinicopathological review of 18 cases. Clin Otolaryngol 1986; 11:31-6. [PMID: 3698325 DOI: 10.1111/j.1365-2273.1986.tb00103.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A variety of nasal conditions may present as simple polypi. Clinically, these lesions, some very rare, present a diagnostic problem. Eighteen cases of unusual lesions which were thought to be simple polyps on clinical grounds are reviewed with the relevant literature. The series includes 2 olfactory neuroblastomas, a haemangiopericytoma and a basal encephalocoele. Atypical features from the history and examination are highlighted. It is emphasized that every nasal polyp must be submitted for histological examination and the pathology report consulted when the patient is reviewed. Failure to do so delays appropriate treatment.
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39
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de Campora E, Calabrese V, Bianchi PM, Camaioni A, Corradini C. Malignant hemangiopericytoma of the nasal cavity. Report of a case and review of the literature. J Laryngol Otol 1983; 97:963-8. [PMID: 6619658 DOI: 10.1017/s0022215100095815] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Haemangiopericytoma is only rarely localized in the nasal cavity. The authors' experience with one case has prompted them to review the literature critically, in order to understand better the most appropriate diagnostic procedures and therapeutic measures.
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40
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Pesavento G, Ferlito A. Haemangiopericytoma of the larynx. A clinico-pathological study with review of the literature. J Laryngol Otol 1982; 96:1065-73. [PMID: 7130846 DOI: 10.1017/s0022215100093506] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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41
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42
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43
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Batsakis JG, Rice DH. The pathology of head and neck tumors: vasoformative tumors, part 9B. HEAD & NECK SURGERY 1981; 3:326-39. [PMID: 6260710 DOI: 10.1002/hed.2890030408] [Citation(s) in RCA: 77] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
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.
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