Recurrent intracranial hemangiopericytoma with extracranial and unusual multiple metastases: case report and review of the literature

Hemangiopericytoma is a rare tumor with uncommon locationin the central nervous system. It has only recently been included(WHO classification 1993) in a specific group of CNStumors and subsequently (WHO classification 1997 and 2000)as a group by itself, while before it was confused withmeningeal tumors. We report on a case of a 48-year-oldwoman affected by this tumor. The neoplasm was located inthe posterior fossa. The patient underwent primary surgery in1990, not followed by any adjuvant therapy because of thehistopathological diagnosis of meningioma. After being freefrom disease for eight years she developed a local recurrencein 1998. Subtotal excision of the tumor, which was finally identifiedas a hemangiopericytoma, was carried out, followed byadjuvant radiotherapy (64 Gy). After six months multiplemetastases were found in the liver and right kidney. A radicalmetastasectomy was performed, followed by systemicchemotherapy. One year later (2001) the tumor recurred againintracranially and a metastases was detected in the rightbreast, so the patient again underwent cranial irradiation (40Gy) and second-line chemotherapy. She died in September2002, 12 years after the diagnosis. We may conclude that, despitethe tumor’s natural tendency to recur several times andthe ability of intracranial hemangiopericytoma to spread outsidethe CNS, it is possible to ensure a long survival time.