Temporal fossa hemangiopericytoma: a case series.
OBJECTIVE
Review clinical experience with temporal fossa hemangiopericytomas (HPCs).


METHODS
Retrospective case series review.


METHODS
Tertiary referral center.


METHODS
Intracranial HPCs within the temporal fossa.


METHODS
Craniotomy for either subtotal or gross total tumor excision.


METHODS
Determination of clinical outcome (alive with no evidence of disease, alive with disease, and died of disease).


RESULTS
Five cases of HPC involving the temporal fossa were treated at our tertiary referral center for the period from 1995 to 2008. All but 1 patient were men. The age of presentation ranged from 31 to 62 years, and duration of follow-up ranged from 8 to 153 months. Clinical presentation was protean; headache was the most common symptom. Gross total tumor excision was achieved in 2 patients, whereas subtotal tumor excision was achieved in 3 patients. Reasons for subtotal resection included excessive intraoperative blood loss and inextricable tumor. Histologically, all tumors were composed of tightly packed, randomly oriented (jumbled-up) tumor cells with little intervening collagen. CD34 staining mostly highlighted the vascular background. One patient died of disease, 2 patients were alive with disease, and 2 patients had no evidence of disease.


CONCLUSIONS
Management of temporal fossa HPC is challenging because clinical presentation is often late, and extent of tumor excision is constrained by vital structures in the cranial base and intracranial contents. A multidisciplinary approach with neurosurgery and neurotology undertaken to achieve the most complete tumor resection possible, whereas minimizing morbidity are likely to confer a longer period of symptom-free survival and improves curability of these difficult lesions.
Heiser
Marc A
MA
Department of Otolaryngology-Head and Neck Surgery, University of California at San Francisco, San Francisco, California 94143-0342, USA. marc.heiser@ucsf.edu
Waldron
James S
JS
Tihan
Tarik
T
Parsa
Andrew T
AT
Cheung
Steven W
SW
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D057210:Delayed Diagnosis; D018572:Disease-Free Survival; D005260:Female; D006261:Headache / Q000209:etiology; D006393:Hemangiopericytoma / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012888:Skull Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
D018952:Antigens, CD34