Brain Tumor Res Treat.  2016 Oct;4(2):128-132. 10.14791/btrt.2016.4.2.128.

Metastatic Intracranial Hemangiopericytoma to the Spinal Column: A Case Report

• Joo MS
• Rho YJ
• Song SW
• Koh YC
• Roh HG
• Lim SD

• KMID: 2356982
• DOI: http://doi.org/10.14791/btrt.2016.4.2.128

Abstract

Intracranial hemangiopericytoma (HPC) is a rare brain tumor with aggressive biologic behavior associated with high recurrence rate and often with extracranial metastasis. The most common sites of extracranial metastasis of the intracranial HPC are the long bones, lung, liver and abdominal cavity in the order of frequencies. Extracranial metastases usually occur long after the initial diagnosis of the primary tumor. Metastatic intracranial HPC to the vertebra has been rarely reported. We present a case of intracranial HPC metastasized to the L2 vertebral body 13 years after multiple surgical resections and radiotherapy of the primary intracranial HPC.

Keyword

Hemangiopericytoma; Metastasis; Surgery; Lumbar vertebrae

MeSH Terms

Abdominal Cavity
Brain Neoplasms
Diagnosis
Hemangiopericytoma*
Liver
Lumbar Vertebrae
Lung
Neoplasm Metastasis
Radiotherapy
Recurrence
Spine*

Figure

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  Fig. 1 Postcontrast axial T1-weighted magnetic resonance findings of intracranial HPC at preoperation and postoperation. A: Preoperative axial T1-weighted magnetic resonance imaging with gadolinium administration showing an intracranial HPC at the right temporo-occipital region. B: Postoperative axial T1-weighted magnetic resonance imaging with gadolinium administration showing gross total removal of the residual-recurrent intracranial HPC. HPC, hemangiopericytoma.

• 

  Fig. 2 Computed tomogram of the spine at the level of L2 reveals invasion of the tumor to vertebral body and anterior epidural space (A and B). T1-weighted image enhanced with gadolinium revealing an isointense lesion in posterior aspect of L2 vertebral body with retropulsion to anterior epidural space (C and D).

• 

  Fig. 3 Postoperative lateral & anteroposterior X-ray (A and B) and saggital & axial MRI (C and D). Grossly total removal of tumor at L2 vertebral body and replacement of bone graft. Transpedicular screw fixation from T12 to L4.

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  Fig. 4 Tumor histopathology. Right temporooccipital region of intracranial HPC (A and C) and metastatic spinal HPC (B and D) in 13 years later. Photomicrograph demonstrating a hemangiopericytoma with a highly cellular and vascular tumor consisting of compact neoplastic cells (A and B; H&E staining). Ki-67 proliferation index is more increased by about 10% in the metastatic spinal HPC as compared with intracranial HPC (C and D; Ki-67 immunohistochemistry). HPC, hemangiopericytoma.

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