J Korean Neurosurg Soc.  2015 Sep;58(3):211-216. 10.3340/jkns.2015.58.3.211.

Intracranial Hemangiopericytomas : A Retrospective Study of 15 Patients with a Special Review of Recurrence

• Noh SH
• Lim JJ
• Cho KG

• KMID: 2191364
• DOI: http://doi.org/10.3340/jkns.2015.58.3.211

Abstract

OBJECTIVE
Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC.
METHODS
Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed.
RESULTS
Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001).
CONCLUSION
Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.

Keyword

Meningeal hemangiopericytoma; Recurrence; Radiation therapy; Extraneural metastasis; Complete resection

MeSH Terms

Hemangiopericytoma*
Humans
Radiosurgery
Radiotherapy
Radiotherapy, Adjuvant
Recurrence*
Retrospective Studies*
Survival Rate

Figure

• 

  Fig. 1 A : Preoperative magnetic resonance (MR) images show a temporal fossa meningeal hemangiopericytoma in Case No. 15. B : Immediate postoperative MR images show that the tumor was completely resected. C : MR images taken 81 months later show tumor recurrence. The patient underwent tumor embolization prior to removal. D : Immediate postoperative MR images show complete resection of the tumor.

• 

  Fig. 2 Kaplan-Meier analysis of recurrence-free survival rates in patients who were and were not treated with adjuvant radiotherapy after complete resection in the first surgery. There was no significant difference between these groups (p=0.3).

• 

  Fig. 3 The Ki-67 index differed significantly between patients who did and did not develop recurrence (p=0.001).

• 

  Fig. 4 Analysis of the recurrence-free survival in our study. The 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively.

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