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Nayani D, Pitale Ashok RK, Loka SR, Jacob AS, Maley S. Breaking New Ground: Unraveling Sinonasal Hemangiopericytoma Through a Rare Case Series on Endoscopic Excision and Postoperative Monitoring. Indian J Otolaryngol Head Neck Surg 2024; 76:3369-3373. [PMID: 39130240 PMCID: PMC11306661 DOI: 10.1007/s12070-024-04692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/04/2024] [Indexed: 08/13/2024] Open
Abstract
Hemangiopericytoma is a rare vascular neoplasm derived from pericytes, with uncertain malignant potential. It mainly occurs in the retroperitoneum and lower extremities, with a lower incidence in the head and neck region and nasal cavity. Diagnosis is aided by histopathological examination and immunohistochemistry. Surgical excision is the preferred treatment, with different approaches depending on tumour size. Endoscopic excision is suitable for small tumours, while larger ones may require external approaches. The recurrence rate is approximately 25%, emphasizing the importance of long-term follow-up. Our study aims to discuss a rare series of sinonasal hemangiopericytoma cases, their clinical presentation, and their management. In this study, we are discussing the prospective study of six cases of sinonasal hemangiopericytoma that were presented to a tertiary hospital, from June 2017 to June 2023, with complaints of nasal obstruction and bleeding episodes. They were assessed with a detailed history, blood investigations, radiological investigations, and diagnostic nasal examination, and underwent endoscopic surgical excision of the nasal mass, with the diagnosis confirmed by histopathological examination and immunohistochemistry. All cases were followed up for 1 year postoperatively, except one case which missed follow-up after 6 months and with no postoperative complications and recurrences. All six cases came with complaints of nasal obstruction and bleeding from the nasal cavity. All six cases underwent endoscopic surgical excision of the tumour and were followed for 1 year in five cases; one case missed follow-up after 6 months of postoperative follow-up, but no recurrence was noted in all the cases. For small-sized hemangiopericytoma tumours, endoscopic excision offers benefits such as improved visualization, easy resection, preservation of the normal anatomical structure, and maintenance of physiological function in the sinonasal cavities. With a recurrence rate of approximately 25%, surgical excision and long-term follow-up play essential roles in successful tumour management.
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Affiliation(s)
- Divya Nayani
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Rahul Kumar Pitale Ashok
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Sudarshan Reddy Loka
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Anju Susan Jacob
- Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No 5-1-174, Opposite State Bank of India Head Office, Bank Street Road, Koti, Hyderabad, 500095 India
| | - Sai Maley
- NRG Oncology/Hillman Cancer Center, NSABP Foundation, Inc., 1307 Federal St, Suite 303, Pittsburgh, PA 15212 USA
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Akhtar K, Ahmed A, Talha M, Warsi S. Sinonasal haemangiopericytoma- An unusual swelling in the nasal cavity. IP JOURNAL OF OTORHINOLARYNGOLOGY AND ALLIED SCIENCE 2020; 3:67-71. [DOI: 10.18231/j.ijoas.2020.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Sinonasal hemangiopericytoma, also known as glomangiopericytoma (GPC) is a benign perivascular tumor of low malignant potential, with an incidence rate of 0.5-1% of all sinonasal tumors. It often shows local recurrences with invasion to the surrounding bony tissues. It usually arises from the perivascular cells surrounding the capillaries. Etiology of the tumour is uncertain, with few postulated hypothesis like pregnancy, trauma, hypertension and corticosteroid drugs. They have an indolent course and tend to occur most commonly in the adults of seventh decade of life. We present a case report of 55 years old male presenting to the ENT OPD, with complaints of right sided nasal obstruction and repeated episodes of epistaxis since the last 9 months. History and general examination was unremarkable except for anti-hypertensive intake since the last few years. Laboratory investigations showed microcytic hypochromic anaemia, raised absolute eosinophil count of 1500 cells per microliter and positive Hepatitis B surface antigen (HBsAg) in the blood. Rhinoscopic examination showed a reddish brown nodular swelling in the right nasal cavity beneath the middle turbinate and hypertrophy of left nasal mucosa. CT imaging suggested an 18x15 mms, well defined soft tissue mass in the right nasal cavity. Complete resection of the mass with endoscopic surgery was performed. Histopathological examination coupled with immunohistochemistry confirmed the diagnosis of Sinonasal Hemangiopericytoma. This case report stresses upon various differential diagnosis of sinonasal swellings and the importance of considering long term follow up of Sinonasal Hemagiopericytoma.
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Ho CL, Lam JJH, Chen RC. Extensive systemic metastases from primary central nervous system haemangiopericytoma. BJR Case Rep 2020; 6:20190081. [PMID: 33029367 PMCID: PMC7526991 DOI: 10.1259/bjrcr.20190081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/09/2020] [Accepted: 02/17/2020] [Indexed: 12/02/2022] Open
Abstract
Primary intracranial tumours rarely metastasise outside of the central nervous system (CNS). This report describes a rare case of recurrent meningeal haemangiopericytoma with extensive systemic metastases, which eventually resulted in a fatal outcome. We discuss some prevailing theories as to the rarity of extracranial metastases from primary CNS haemangiopericytoma, and elucidate the epidemiology, imaging features, differential diagnosis, treatment, and prognosis of this unusual but surprisingly aggressive meningeal tumour. Besides aggressive treatment for local tumour control, patients with primary CNS haemangiopericytoma require long-term post-treatment surveillance to detect systemic metastases.
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Affiliation(s)
- Chi Long Ho
- Department of Radiology, Sengkang General Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Duke-NUS (National University of Singapore) Graduate Medical School, Singapore, Singapore
| | - Jeremy JH Lam
- Department of Radiology, Changi General Hospital, Singapore, Singapore
| | - Robert Chun Chen
- Duke-NUS (National University of Singapore) Graduate Medical School, Singapore, Singapore
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
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Lim M, Kheok SW, Lim KC, Venkatanarasimha N, Small JE, Chen RC. Subdural haematoma mimics. Clin Radiol 2019; 74:663-675. [PMID: 31109715 DOI: 10.1016/j.crad.2019.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 04/09/2019] [Indexed: 11/30/2022]
Abstract
A subdural haematoma (SDH) is a frequently encountered pathology seen on an emergency room computed tomography (CT) head scan. An extra-axial crescentic density along the convexity of the brain or within the interhemispheric fissure is generally thought to represent a SDH; however, SDH mimics are known to occur in nature, and can be broadly classified under the subcategories of normal anatomy, artefacts, tumour, inflammation, infection, ischaemia, trauma, and iatrogenic. Understanding the typical characteristics of a SDH, knowledge of normal anatomy, close inspection of the morphology of the subdural process, changes to the adjacent structures, and rigorous attention to clinical details may reveal subtle clues that distinguish a true SDH from a mimic. This is crucial in appropriately directing clinical management. This review amalgamates most of the rare subdural processes that have been reported to mimic SDH, and discusses the imaging and clinical features that help to differentiate between them. This topic is highly valuable for radiology trainees, general radiologists, and emergency room physicians, and may serve as a refresher for the practising neuroradiologist.
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Affiliation(s)
- M Lim
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
| | - S W Kheok
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - K C Lim
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - N Venkatanarasimha
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - J E Small
- Neuroradiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - R C Chen
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
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Wushou A, Bai XF, Qi H, Xu Z, Zheng J, Li G. Haemangiopericytoma of the jaw. J Craniomaxillofac Surg 2013; 42:689-94. [PMID: 24252622 DOI: 10.1016/j.jcms.2013.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/07/2013] [Accepted: 09/30/2013] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Alimujiang Wushou
- Department of Oncology, Cancer Hospital/Cancer Institute, Shanghai Medical College, Fudan University, Shanghai, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Xiu Feng Bai
- Department of Oral and Maxillofacial-Head and Neck Oncology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Hong Qi
- Department of Oral Pathology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Zhe Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Jun Zheng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Gang Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Stomatology Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China.
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Aliberti C, Benea G, Kopf B, De Giorgi U. Hepatic metastases of hemangiopericytoma: contrast-enhanced MRI, contrast-enhanced ultrasonography and angiography findings. Cancer Imaging 2006; 6:56-9. [PMID: 16766270 PMCID: PMC1693778 DOI: 10.1102/1470-7330.2006.0011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Hemangiopericytoma is a rare and characteristically hypervascular tumour. We report a case of hepatic metastases of hemangiopericytoma for which there was correlative imaging by ultrasonography, ultrasonography with second-generation contrast agent (BR1), computed tomography, gadolinium-enhanced, Gd-BOPTA-enhanced and ferumoxides-enhanced magnetic resonance, and angiography. To our knowledge, this is the first reported case in which all these modalities were used in the diagnostic evaluation.
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Affiliation(s)
- Camillo Aliberti
- Department of Imaging, Delta Hospital, Lagosanto, Ferrara, Italy.
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Palacios E, Restrepo S, Mastrogiovanni L, Lorusso GD, Rojas R. Sinonasal Hemangiopericytomas: Clinicopathologic and Imaging Findings. EAR, NOSE & THROAT JOURNAL 2005. [DOI: 10.1177/014556130508400214] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hemangiopericytomas are rare soft-tissue neoplastic lesions that can arise in any part of the body. They are mesenchymal tumors that account for 3 to 5% of all soft-tissue sarcomas and 1% of all vascular tumors. They originate in extravascular cells (pericytes). Some 15 to 30% of all hemangiopericytomas occur in the head and neck; of these, approximately 5% occur in the sinonasal area. We describe our brief retrospective review of 7 histologically proven cases of sinonasal hemangiopericytoma, and we discuss the imaging characteristics and clinical and pathologic findings in these patients.
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Affiliation(s)
- Enrique Palacios
- From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Santiago Restrepo
- From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Luciano Mastrogiovanni
- From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Giovanni D. Lorusso
- Department of Pathology, Louisiana State University Health Sciences Center, New Orleans
| | - Rafael Rojas
- From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
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Ueno M, Nakashima O, Mishima M, Yamada M, Kikuno M, Nasu K, Kudo S. Pulmonary glomus tumor: CT and MRI findings. J Thorac Imaging 2004; 19:131-4. [PMID: 15071335 DOI: 10.1097/00005382-200404000-00015] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Pulmonary glomus tumor is rare and its manifestations on magnetic resonance imaging (MRI) have not, to our knowledge, been reported previously. A round mass was detected in the right upper lung field on a routine chest radiograph. With dynamic contrast-enhanced MRI, the mass showed strong, early-phase peripheral enhancement that expanded in a centripetal direction with time. Postoperative pathologic examination confirmed the diagnosis of glomus tumor.
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Affiliation(s)
- Masako Ueno
- Department of Radiology, Takagi Hospital, Okawa City, Fukuoka, Japan.
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