Siegel Herrick J, Lopez-Ben Robert, Sutton J Hunter, Siegal Gene P
University of Alabama at Birmingham, Orthopaedic Specialty Bldg, 1313 13th St S, Birmingham, AL 35205, USA.
Orthopedics. 2012 Jan 16;35(1):e112-5. doi: 10.3928/01477447-20111122-37.
Meningeal hemangiopericytomas are rare vascular tumors that have a propensity for recurrence and metastasis. Intracranial hemangiopericytomas are rare vascular tumors. They account for 0.5% of primary central nervous system tumors and 2% of meningiomas. Unlike usual benign meningiomas, which rarely metastasize extracranially, meningeal hemangiopericytoma has a high rate of local recurrence and distant metastasis. The treatment paradigms for hemangiopericytomas and meningiomas differ based on their biological behaviors. Hemangiopericytomas have higher rates of recurrence and metastasis compared with meningiomas. Intracranial meningeal hemangiopericytoma is characterized by clinically repeated local recurrences at the primary site. Bone, liver, lung, central nervous system, and abdominal cavity are the most commonly reported sites of metastasis in hemangiopericytomas.This article describes a case of bone metastasis with extensive involvement of the scapula from intracranial hemangiopericytoma. Bone metastasis can be seen in a relatively late phase of the disease, with metastasis to other organs. Although radiation therapy is effective in controlling pain from bone metastases in unresectable disease and those with extensive visceral metastases, aggressive local surgical control of a solitary bone metastasis may be an option for patients with limited distant disease. The diagnosis may be initially confused with clear cell meningioma and benign meningiomas. The management of bone metastasis is not well reported in the orthopedic literature.
脑膜血管外皮细胞瘤是一种罕见的血管肿瘤，有复发和转移倾向。颅内血管外皮细胞瘤是罕见的血管肿瘤。它们占原发性中枢神经系统肿瘤的0.5%，占脑膜瘤的2%。与通常很少发生颅外转移的良性脑膜瘤不同，脑膜血管外皮细胞瘤局部复发和远处转移率很高。血管外皮细胞瘤和脑膜瘤的治疗模式因其生物学行为而异。与脑膜瘤相比，血管外皮细胞瘤的复发和转移率更高。颅内脑膜血管外皮细胞瘤的特点是临床上在原发部位反复局部复发。骨、肝、肺、中枢神经系统和腹腔是血管外皮细胞瘤最常报道的转移部位。本文描述了一例颅内血管外皮细胞瘤骨转移并广泛累及肩胛骨的病例。骨转移可见于疾病相对较晚阶段，并伴有其他器官转移。虽然放射治疗对控制不可切除疾病及广泛内脏转移患者的骨转移疼痛有效，但对于远处疾病局限的患者，积极的局部手术控制孤立性骨转移可能是一种选择。该诊断最初可能与透明细胞脑膜瘤和良性脑膜瘤混淆。骨科文献中关于骨转移的治疗报道不多。
