Intracranial meningeal hemangiopericytoma: 10 years experience of a tertiary care Institute.
BACKGROUND
Intracranial meningeal hemangiopericytoma (HPC) represents a rare and aggressive intracranial neoplasm located along the dural sinuses. It constitutes less than 1 % of all intracranial tumors and approximately 2-4 % of all meningeal tumors. The authors present our institute's experience in combined modality management of 15 successive patients of HPC.


METHODS
We retrospectively reviewed 15 patients of HPC treated in our institute from 2001 to 2011. Clinical characteristics and treatment modality, in the form of surgery and radiotherapy, were noted. Statistical analysis was done with regards to recurrence free survival (RFS) and overall survival (OS) using Kaplan-Meier survival analysis.


RESULTS
The median age of the patients was 40.0 years. Nine patients were males and six patients were females. The median duration of symptoms was six months. Headache was the most common presenting symptom followed by vomiting, motor weakness and seizures. Twelve patients underwent total excision while three had subtotal excision. Seven patients had WHO grade II histology tumors and eight patients had grade III histology. Thirteen patients received adjuvant radiotherapy (RT). Median RT dose delivered was 50 Gy. Five patients developed local recurrence. One patient had distant metastases. Median duration of RFS was 68 months.


CONCLUSIONS
HPCs are aggressive tumors. The mainstay of therapy is gross total resection at the initial surgery. Postoperative adjuvant RT should be offered to all patients, regardless of the degree of resection achieved. Long-term follow-up is important as local recurrences and distant metastases can develop years after the initial treatment.
Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drnarendra74@gmail.com
Narendra
N
Kumar
Ritesh
R
Kumar
Rakesh
R
Kapoor
Sushmita
S
Ghoshal
Pramod
P
Kumar
Pravin S
PS
Salunke
B D
BD
Radotra
Suresh Chander
SC
Sharma
D000046:Academic Medical Centers; D000328:Adult; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006393:Hemangiopericytoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed