Meningeal hemangiopericytomas: long-term outcome and biological behavior.
BACKGROUND
The authors present a retrospective clinical analysis of meningeal hemangiopericytomas. The long-term outcome and biologic behavior, including local recurrence and extraneural distant metastasis, are elucidated.


METHODS
Clinical records and radiologic findings of 31 cases with meningeal hemangiopericytoma treated at Seoul National University Hospital and Asian Medical Center between 1982 and 1999 were carefully reviewed. The final outcome was determined by direct or phone contact and questionnaire by mail. The duration of follow-up was from 1 to 216 months (mean 77). All patients underwent craniotomy and Simpson Grade I or II resection was possible in 24 patients. Conventional radiotherapy was given in 11 patients (in 5 after total excision and in 6 for residual mass) and stereotactic radiosurgery was conducted in 6 cases.


RESULTS
Intracranial recurrence was seen in 12 cases (38.7%) and the mean period before the first recurrence was 104 months. The recurrence was at the primary site in 11 cases and diffuse leptomeningeal seeding occurred in the remaining case. The 5-year recurrence free rate was 59.2% and the extent of excision was the significant factor (72.7% in total excision group and 20.8% in the incomplete excision group, p = 0.006). In four patients (12.9%), extraneural metastases developed at an average of 107 months. Six patients died during the follow-up period; however, 2 of these died of unrelated causes.


CONCLUSIONS
Complete excision is the most important factor in reducing recurrence. However, recurrence may occur even after complete excision. Careful long-term follow-up is mandatory because of the long disease-free interval.
Kim
Jeong Hoon
JH
Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
Jung
Hee-Won
HW
Kim
Yong-Su
YS
Kim
Chang Jin
CJ
Hwang
Sung-Kyun
SK
Paek
Sun Ha
SH
Kim
Dong Gyu
DG
Kwun
Byung Duk
BD
D000328:Adult; D005260:Female; D006393:Hemangiopericytoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis; D016896:Treatment Outcome