Clinical features of malignant haemangiopericytomas and haemangioendotheliosarcomas

Malign recurrence of primary chest wall hemangiopericytoma in the lung after four years: a case report and review of the literature

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.

Head and Neck Angiosarcomas

Angiosarcoma of the head and neck is a rare and lethal neoplasm. Data from the Connecticut Tumor Registry was analyzed for all head and neck angiosarcomas between 1980 and 2001. The authors also present the first reported case of familial angiosarcoma of the head and neck region. The 1-year mortality was 48% for all patients with angiosarcomas (38% for males, 69% for females). The 5-year survival was 28% for all patients (38% for males, 15% for females). The combination of surgery and radiotherapy resulted in improved survival compared with either treatment alone.

Malignant hemangiopericytoma: a clinical overview and case study

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.

Hemangiopericytoma: a 20-year single-institution experience

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.