Meningeal hemangiopericytomas (HPCs) are rare tumors that mimic meningiomas radiologically but constitute a distinct clinicopathologic entity. Our operative series of 21 patients with HPCs attempts to review the clinical characteristics of this rare entity.
This is a retrospective analysis of the case records of all the patients with HPC operated on since 2000 with a minimum of 2 years of follow-up. The following prognostic factors were analyzed for statistical significance—age, sex, location, extent of resection, histopathologic grade, and use of radiotherapy.
The study group included 21 patients with a mean age of 38.12 years (range, 13 to 67 y) and with no preferential sex distribution (M:F=11:10). A raised intracranial headache was the predominant presenting complaint (13/21; 61.9%). A predominant skull-base location (13/21, 61.9%) was observed in our series. Gross total removal could be achieved in only 13 cases (61.9%). Majority (18/21; 85.71%) were well-differentiated HPCs. At the end of a mean follow-up period of 4.63 years (range, 2 to 11 y), majority of the patients had a good outcome (16/21, 76.1%) and were in the Glasgow outcome score 1. The mean recurrence-free survival after the first surgery was 3.36 years. Recurrence-free survival with gross total removal (3. 95 y) was superior to subtotal removal (STR) alone (2.4 y) and STR with radiotherapy (2.67 y).
HPCs are rare tumors that mimic aggressive meningiomas clinically but have a different histogenesis. HPCs are extremely vascular tumors and more commonly occur at skull-base locations, making radical removal a surgical challenge. Radical surgery is the treatment of choice, and the role of adjuvant therapy as a supplement to STR is yet to be established. Long-term follow-up is mandatory as HPCs carry a risk of local recurrence and distant metastases even many years after diagnosis.
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
The authors declare no conflict of interest.
Reprints: Girish R. Menon, MCh, DNB, Department of Neurosurgery, SCTIMST, Trivandrum 695011, Kerala, India (e-mail: firstname.lastname@example.org).