Kim Bong-Wan, Wang Hee-Jung, Jeong In-Ho, Ahn Sang-Ick, Kim Myoung-Wook
Department of Surgery, Ajou University School of Medicine, Wonchon dong, Suwon 442-749, South Korea.
World J Gastroenterol. 2005 Jul 21;11(27):4281-4. doi: 10.3748/wjg.v11.i27.4281.
Hemangiopericytoma is a rare tumor especially when it rises in the peritoneal cavity. We present a case of a 60-year-old woman with an isolated recurrent hemangiopericytoma of the liver. The patient presented with a palpable right upper quadrant abdominal mass, which occurred 7 years after undergoing resection of a malignant hemangiopericytoma arising from the greater omentum. She had not followed up 6 mo after surgery. Various imaging studies showed a single large, well-capsulated liver tumor with central necrosis, accompanied by hypervascularity typical of a vascular tumor. Preoperative laboratory HBsAg and anti-HCV workup were both negative. Under the impression of recurrent malignant hemangiopericytoma, right trisegmentectomy was performed to completely resect the tumor. Pathological examination confirmed the diagnosis of recurrent hemangiopericytoma. Even though the incidence of the hemangiopericytoma is relatively low, malignant hemangiopericytoma has a tendency to recur frequently after a long-term disease-free interval. Also, the recurrent hemangiopericytoma is not easily detected early during follow-up until it becomes symptomatic because there are no specific tumor markers, and because of the diversity with regard to site of recurrence. The authors suggest that Positron Emission Tomogram (PET) may be a useful tool for the detection of recurrent hemangiopericytoma. We describe herein some characteristics and behaviors of malignant hemangiopericytoma, particularly after surgical resection.
血管外皮细胞瘤是一种罕见的肿瘤,尤其是发生在腹膜腔时。我们报告一例60岁女性,患有孤立性复发性肝脏血管外皮细胞瘤。患者出现右上腹可触及肿块,该肿块在切除源于大网膜的恶性血管外皮细胞瘤7年后出现。她术后6个月未进行随访。各种影像学检查显示肝脏有一个单一的大肿块,边界清晰,伴有中央坏死,具有血管肿瘤典型的高血供特征。术前实验室检查乙肝表面抗原和抗丙肝病毒检查均为阴性。在复发性恶性血管外皮细胞瘤的诊断下,进行了右三叶切除术以完全切除肿瘤。病理检查确诊为复发性血管外皮细胞瘤。尽管血管外皮细胞瘤的发病率相对较低,但恶性血管外皮细胞瘤在长期无病期后有频繁复发的倾向。此外,复发性血管外皮细胞瘤在随访早期不易被发现,直到出现症状,因为没有特异性肿瘤标志物,且复发部位多样。作者认为正电子发射断层扫描(PET)可能是检测复发性血管外皮细胞瘤的有用工具。我们在此描述了恶性血管外皮细胞瘤的一些特征和行为,特别是在手术切除后的情况。