title: Hemangiopericytoma in the setting of acromegaly.
abstract: Acromegaly is associated with an increased incidence of neoplasia thought to be related in part to tonic increases in circulating levels of insulin-like growth factor-1 (IGF-1). Hemangiopericytomas, particularly those occurring in soft tissues, are known to possess IGF receptors. These tumors often behave aggressively and can be recalcitrant to surgery and radiation therapy. A 49-yr-old man presented with an erosive, midline scalp mass and cutis gyrata. Further diagnostic imaging and endocrinologic analysis confirmed two diagnoses: a hemangiopericytoma and acromegaly associated with an intrasellar pituitary tumor. Both the hemangiopericytoma and the pituitary adenoma were surgically resected; Western blot analysis confirmed the presence of IGF-1 receptors in the hemangiopericytoma. Two years later, the patient underwent resection of a right frontal hemangiopericytoma with an identical histologic phenotype and receptor positivity for IGF-1. The occurrence of a central nervous system hemangiopericytoma in patient with acromegaly is rare. Growth and recurrence of hemangiopericytoma may have been fostered by the presence of IGF-1 receptors. Paracrine mechanisms related to IGF-1 may have contributed to its pathogenesis and growth. The presence of IGF-1 receptors in hemangiopericytomas may have treatment implications for additional adjuvant therapies.
authors.affiliation: Department of Neurosurgery, Health Sciences Center, University of Virginia, Charlottesville, VA 22908, USA. wje4r@virginia.edu
authors.forename: W Jeffrey
authors.initials: WJ
authors.lastname: Elias
authors.forename: Isa M
authors.initials: IM
authors.lastname: Hussaina
authors.forename: James B
authors.initials: JB
authors.lastname: Chadduck
authors.forename: John A
authors.initials: JA
authors.lastname: Jane
authors.forename: Edward R
authors.initials: ER
authors.lastname: Laws
authors.forename: M Beatriz S
authors.initials: MB
authors.lastname: Lopes
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000473:pathology*; D000236:Adenoma / Q000150:complications / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003399:Craniotomy; D013006:Growth Hormone / Q000378:metabolism; D006393:Hemangiopericytoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D013006:Growth Hormone