Satayasoontorn Kantang, Righi Alberto, Gambarotti Marco, Merlino Biagio, Brunocilla Eugenio, Vanel Daniel
Royal Thai Army Institute of Pathology, Bangkok, Thailand,
Skeletal Radiol. 2014 Nov;43(11):1543-9. doi: 10.1007/s00256-014-1926-2. Epub 2014 Jun 17.
Hemangiopericytoma is a rare neoplasm. Primary meningeal hemangiopericytomas account for 1 to 7% of all meningeal tumors. In the literature, meningeal hemangiopericytomas are mainly case reports, which confirm an aggressive behavior with a high rate of local recurrence and extracranial metastasis. Metastasis can be seen many years after initial surgical excision of the primary tumor, and the most common sites include the bone, liver and lung. We present a pathological study of four meningeal hemangiopericytomas with bone metastases. All patients are male with a mean age of 46.5 years. Metastases only involved bone. Three out of four lesions were initially misdiagnosed as meningiomas. Only one case was initially correctly diagnosed as meningeal hemangiopericytoma. All patients underwent surgery with complete resection. Only the patient immediately diagnosed with meningeal hemangiopericytoma received postoperative radiation therapy. Three patients had bone metastases without local recurrence including the one who received radiation therapy. One patient recurred locally after 7 years, and bone metastasis was found at the same time. Our cases confirm that meningeal hemangiopericytomas are a separate entity and have a high recurrence rate despite complete surgical resection, with extracranial metastases, mainly to bone, even after long intervals.
血管外皮细胞瘤是一种罕见的肿瘤。原发性脑膜血管外皮细胞瘤占所有脑膜肿瘤的1%至7%。在文献中，脑膜血管外皮细胞瘤主要是病例报告，证实其具有侵袭性，局部复发率和颅外转移率都很高。转移可在原发性肿瘤初次手术切除多年后出现，最常见的部位包括骨、肝和肺。我们展示了4例伴有骨转移的脑膜血管外皮细胞瘤的病理研究。所有患者均为男性，平均年龄46.5岁。转移仅累及骨。4个病灶中有3个最初被误诊为脑膜瘤。只有1例最初被正确诊断为脑膜血管外皮细胞瘤。所有患者均接受了手术全切。只有立即被诊断为脑膜血管外皮细胞瘤的患者接受了术后放疗。3例患者有骨转移但无局部复发，包括接受放疗的那例。1例患者在7年后局部复发，同时发现骨转移。我们的病例证实，脑膜血管外皮细胞瘤是一个独立的实体，尽管手术全切，但其复发率很高，会发生颅外转移，主要转移至骨，甚至在很长时间后仍会发生。
