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Meningeal Hemangiopericytomas: Review of An Institutional Series of 21 Cases

Menon, Girish R. MCh, DNB; Patil, Akshay MS; Pisharody, Krishnakumar K. MS, MCh; Nair, Suresh N. MCh

doi: 10.1097/WNQ.0000000000000029
Original Articles
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Objective: 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.

Materials and Methods: 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.

Results: 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).

Conclusions: 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: gmr@sctimst.ac.in).

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