title: Metastatic hemangiopericytoma presenting as an epidural spinal cord lesion.
abstract: OBJECTIVE
  Hemangiopericytoma is an aggressive vascular tumour that rarely affects the central nervous system and is even more rarely spinal in presentation. The clinical features of a patient with a recurrent extraspinal hemangiopericytoma presenting with an epidural spinal cord compression by local invasion are described, including a review of the literature on metastatic hemangiopericytoma to the spine.
  
  
  METHODS
  A case of a 53-year-old male, with a recurrent extraspinal hemangiopericytoma which metastasized to the thoracic spine five years after detection of the primary tumour is presented. A chart review was conducted where all pertinent history, physical, laboratory, and radiological data were collected. A Pub-Med search using the keyword "hemangiopericytoma" identified all reported cases documenting clinical features, treatment, recurrence and outcome with respect to metastatic hemangiopericytoma to the spine.
  
  
  RESULTS
  Nine patients have been reported to have metastatic hemangiopericytoma to the spine. The median patient age was 47 years and there was a slight male preference. An unusual feature of the hemangiopericytoma is the prolonged period, up to 16 years, between the diagnosis of the primary hemangiopericytoma and the metastases to the spine. All patients were treated with a combination of radiation and surgery.
  
  
  CONCLUSIONS
  Hemangiopericytomas show a slow clinical evolution with a strong propensity to relapse long after previous treatment and thus, once identified, prolonged follow-up for recurrence is indicated. A close follow-up of these patients is required because of frequent recurrences and delayed metastases even if the primary lesion was well-controlled. Although overall uncommon, hemangiopericytoma should be kept in mind in the differential diagnosis of vascular epidural spinal cord tumours.
authors.affiliation: Department of Neurology, Harvard University, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Steven David
authors.initials: SD
authors.lastname: Brass
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Guiot
authors.forename: Steffen
authors.initials: S
authors.lastname: Albrecht
authors.forename: Rafael
authors.initials: R
authors.lastname: Glikstein
authors.forename: Gérard
authors.initials: G
authors.lastname: Mohr
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001415:Back; D015174:Epidural Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D005500:Follow-Up Studies; D006393:Hemangiopericytoma / Q000150:complications / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary; D013904:Thoracic Vertebrae; D016896:Treatment Outcome