Brain Tumor Res Treat.  2019 Apr;7(1):53-56. 10.14791/btrt.2019.7.e27.

Primary Intraparenchymal Central Nervous System Solitary Fibrous Tumor/Hemangiopericytoma Presenting with Intracerebral Hemorrhage: A Case Report

Affiliations
  • 1Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Korea. jung-ty@chonnam.ac.kr
  • 2Department of Pathology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea.
  • 3Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Abstract

A 53-year old man who had a left hemiparesis from head injury of traffic accident 20 years ago visited an emergency room with suddenly developed semi-comatose mental status. Brain CT showed 8.6-cm sized solid and cystic mass on right temporal lobe that was associated with hemorrhage. Solid lesion showed a strong enhancement after an administration of contrast media. Because of severe mass effect, emergency operation was performed. The mass was an intraparenchymal lesion with yellowish cystic fluid and the firm reddish-brown solid lesion was hemorrhagic. The lesion was totally resected. Pathologically, anaplastic solitary fibrous tumor/hemangiopericytoma was diagnosed with 70/10 high power fields. Postoperative radiotherapy of 50 Gy was done. Postoperative 2 months later, the patient was recovered to alert mental state. We report this unusual case of non-dural based intraparenchymal solitary fibrous tumor/hemangiopericytoma with high mitotic index and acute massive hemorrhage. Rapid tumor growth of hypervascular tumor might have a chance of bleeding.

Keyword

Solitary fibrous tumors; Hemangiopericytoma; Hemorrhage; Brain neoplasms

MeSH Terms

Accidents, Traffic
Brain
Brain Neoplasms
Central Nervous System*
Cerebral Hemorrhage*
Contrast Media
Craniocerebral Trauma
Emergencies
Emergency Service, Hospital
Hemangiopericytoma
Hemorrhage
Humans
Mitotic Index
Paresis
Radiotherapy
Solitary Fibrous Tumors
Temporal Lobe
Contrast Media

Figure

  • Fig. 1 Radiologic and operative findings. A: Preoperative brain CT shows 8.6-cm-sized solid and cystic mass on right temporal lobe that is associated with hemorrhage and severe mass effect. B: The solid lesion is strongly enhanced after an administration of contrast media. C: Intraoperatively, the mass is an intraparenchymal hemorrhagic lesion with non-dural origin. D: Postoperative 4 months later, MRI shows no enhancing lesion on the right temporal lobe.

  • Fig. 2 Pathologic findings of anaplastic solitary fibrous tumor/hemangiopericytoma. Hypocellular and hypercellular areas are divided by hyalinized band with staghorn-like vasculatures (hematoxylin and eosin staining, original magnification ×100) (A). They show high mitotic index with 70/10 high power fields (red arrows: mitoses, hematoxylin and eosin staining, original magnification ×400) (B) and immunopositivity for STAT6 (immunohistochemistry, original magnification ×400) (C).


Reference

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