Meningeal hemangiopericytomas: Review of an institutional series of 21 cases

G.R. Menon, A. Patil, K.K. Pisharody, S.N. Nair

Research output: Contribution to journalArticle

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Abstract

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. © 2013 Wolters Kluwer Health, Inc.
Original languageEnglish
Pages (from-to)219-227
Number of pages9
JournalNeurosurgery Quarterly
Volume25
Issue number2
DOIs
Publication statusPublished - 2015

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Hemangiopericytoma
Skull Base
Meningioma
Recurrence
Radiotherapy
Neoplasms
Sex Distribution
Survival
Blood Vessels
Headache
Neoplasm Metastasis
Health
Therapeutics

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Menon, G.R. ; Patil, A. ; Pisharody, K.K. ; Nair, S.N. / Meningeal hemangiopericytomas: Review of an institutional series of 21 cases. In: Neurosurgery Quarterly. 2015 ; Vol. 25, No. 2. pp. 219-227.
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abstract = "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. {\circledC} 2013 Wolters Kluwer Health, Inc.",
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Meningeal hemangiopericytomas: Review of an institutional series of 21 cases. / Menon, G.R.; Patil, A.; Pisharody, K.K.; Nair, S.N.

In: Neurosurgery Quarterly, Vol. 25, No. 2, 2015, p. 219-227.

Research output: Contribution to journalArticle

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AB - 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. © 2013 Wolters Kluwer Health, Inc.

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