Intradural hemangiopericytoma of the lumbar spine: case report.
OBJECTIVE
Hemangiopericytoma is a rare tumor of the central nervous system, most often found supratentorially. Thirty-nine cases within the spinal column, of which five were intradural, have been reported. To date, no magnetic resonance imaging descriptions of intradural hemangiopericytomas have been published. This article is the first report of an intradural hemangiopericytoma of the lumbar spine and the first magnetic resonance imaging description of such a lesion.


METHODS
A 31-year-old man presented with progressive bilateral leg paresthesia and increased lower extremity cramping and fatigue during a period of several months. This progressed to urinary urgency, frequency, and sexual dysfunction. A neurological examination revealed no motor or sensory deficits. Gadolinium-enhanced magnetic resonance imaging of the lumbar spine revealed a centrally located intradural mass posterior to the L4 vertebral body.


METHODS
The patient underwent a laminectomy of L4 and partial laminectomy of L3 with complete en bloc resection of the tumor. A discrete, intradural, red-appearing lesion was found and resected en bloc. Pathological findings were consistent with hemangiopericytoma.


CONCLUSIONS
Intradural hemangiopericytomas, although rare, cannot be differentiated from other, more benign tumors. Spinal hemangiopericytomas ideally should be resected en bloc to reduce operative blood loss and potentially increase disease-free survival time. Despite total surgical resection of these benign-seeming lesions, the high recurrence rate mandates close follow-up and consideration of adjuvant therapy.
Betchen
Simone
S
Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York, USA. betchs01@doc.mssm.edu
Schwartz
Amit
A
Black
Candice
C
Post
Kalmon
K
D000328:Adult; D004388:Dura Mater; D006393:Hemangiopericytoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*