J Korean Neurosurg Soc.  2013 Oct;54(4):309-316. 10.3340/jkns.2013.54.4.309.

Clinical Analysis of Intracranial Hemangiopericytoma

• Park BJ
• Kim YI
• Hong YK
• Jeun SS
• Lee KS
• Lee YS

• KMID: 1499336
• DOI: http://doi.org/10.3340/jkns.2013.54.4.309

Abstract

OBJECTIVE
Intracranial hemangiopericytomas (HPCs) are rare tumors with aggressive behavior, including local recurrence and distant metastasis. We conducted this retrospective study to evaluate the efficacy of grossly total resection and adjuvant radiotherapy (RT) for these tumors.
METHODS
A total of 13 patients treated for intracranial HPC from January 1995 through May 2013 were included in this retrospective study. We analyzed the clinical presentations, radiologic appearances, treatment results, and follow-up outcomes, as well as reviewed other studies.
RESULTS
The ages of the patients at the time of diagnosis ranged from 26 to 73 years (mean : 48 years). The majority of the patients were male (92.3%), and the majority of the tumors were located in the parasagittal and falx. The ratio of intracranial HPCs to meningiomas was 13 : 598 in same period, or 2.2%. Seven patients (53.8%) had anaplastic HPCs. Nine patients (69.2%) underwent gross total tumor resection in the first operation without mortality. Eleven patients (84.6%) underwent postoperative adjuvant RT. Follow-up period ranged from 13 to 185 months (mean : 54.3 months). The local recurrence rate was 46.2% (6/13), and there were no distant metastases. The 10-year survival rate after initial surgery was 83.9%. The initial mean Karnofsky performance scale (KPS) was 70.8 and the final mean KPS was 64.6.
CONCLUSION
Gross total tumor resection upon initial surgery is very important. We believe that adjuvant RT is helpful even with maximal tumor resection. Molecular biologic analyses and chemotherapy studies are required to achieve better outcomes in recurrent intracranial HPCs.

Keyword

Hemangiopericytoma; Intracranial; Radiotherapy; Surgery; Adjuvant; Recurrence

MeSH Terms

Diagnosis
Drug Therapy
Follow-Up Studies
General Surgery
Hemangiopericytoma*
Humans
Male
Meningioma
Mortality
Neoplasm Metastasis
Radiotherapy
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Survival Rate

Figure

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  Fig. 1 Bone erosion on the right occipital due to intracranial hemangiopericytomas.

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  Fig. 2 Intracerebral hemorrhage from hemangiopericytomas on a CT scan.

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  Fig. 3 Preoperative tumor embolization. A : The digital subtraction angiography (DSA) shows a hypervascular contrast staining mass with an arterial feeder from the MCA and PCA. B : The postembolic DSA shows near total occlusion of the feeding arteries and decreased size of the contrast staining mass.

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  Fig. 4 Pathologic features of low grade hemangiopericytomas. A : Hematoxylin and eosin, ×200. B : CD34, ×200. C : Ki-67, ×200.

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  Fig. 5 Pathologic features of anaplastic hemangiopericytomas. A and B : Hematoxylin and eosin, ×200. C : CD34, ×200. D : Ki-67, ×200.

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  Fig. 6 Analysis of the recurrence-free survival in our study.

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  Fig. 7 Correlation analysis between extent of resection and recurrence-free survival.

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  Fig. 8 Correlation analysis between adjuvant radiotherapy and recurrence-free survival.

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  Fig. 9 Analysis of the overall survival in our study.

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