Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Spinal Hemangiopericytoma Which Needed Intraoperative Embolization due to Unexpected Bleeding

  • Lee, Chang-Hyun (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Ki-Jeong (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Hyun-Jib (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • Received : 2013.05.07
  • Accepted : 2013.09.08
  • Published : 2013.09.28
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Abstract

Spinal intradural hemangiopericytoma is a very rare tumor and can be characterized by massive bleeding during surgeries, frequent recurrence, and metastasis. However, definite radiologic differential points of hemangiopericytoma are not known. We describe an unexpected hemangiopericytoma case with large bleeding and management of the tumor. A 21-year-old man visited complaining of progressive neck pain and tingling sensation in both hands. Magnetic resonance imaging of his spine revealed C1-2 ventral intradural mass. When the dura was opened, the intradural tumor was placed behind spinal accessary nerves. The tumor was partially exposed only after some accessary nerves had been cut. When internal debulking was performing, unexpected bleeding was noted and it was difficult to control because of narrow surgical field and hypervascularity. Intraoperative spinal angiography and embolization were performed. The tumor was completely removed after embolization. Pathological diagnosis was consistent with hemangiopericytoma. When surgeons meet a flesh-red tumor that bleeds unexpectedly during surgery, hemangiopericytoma may be considered. When feeder control is hard due to reciprocal location of spinal cord, the tumor, and feeders, intraoperative angiography and embolization may be a possible option.

Keywords

References

  1. Ackerman PD, Khaldi A, Shea JF : Intradural hemangiopericytoma of the thoracic spine : a case report. Spine J 11 : e9-e14, 2011
  2. Betchen S, Schwartz A, Black C, Post K : Intradural hemangiopericytoma of the lumbar spine : case report. Neurosurgery 50 : 654-657, 2002
  3. Ciappetta P, Celli P, Palma L, Mariottini A : Intraspinal hemangiopericytomas. Report of two cases and review of the literature. Spine (Phila Pa 1976) 10 : 27-31, 1985 https://doi.org/10.1097/00007632-198501000-00005
  4. Dufour H, Métellus P, Fuentes S, Murracciole X, Régis J, Figarella-Branger D, et al. : Meningeal hemangiopericytoma : a retrospective study of 21 patients with special review of postoperative external radiotherapy. Neurosurgery 48 : 756-762; discussion 762-763, 2001
  5. Fitzpatrick D, Mahajan J, Lewkowitz M, Black K, Setton A, Woldenberg R : Intradural hemangiopericytoma of the lumbar spine : a rare entity. AJNR Am J Neuroradiol 30 : 152-154, 2009 https://doi.org/10.3174/ajnr.A1731
  6. Guthrie BL, Ebersold MJ, Scheithauer BW, Shaw EG : Meningeal hemangiopericytoma : histopathological features, treatment, and long-term follow-up of 44 cases. Neurosurgery 25 : 514-522, 1989 https://doi.org/10.1227/00006123-198910000-00003
  7. Jang JH, Rhim SC, Lee DG, Roh SW : Multiple spinal metastases of hemangiopericytoma : case report. J Korean Neurosurg Soc 32 : 380-383, 2002
  8. Jääskeläinen J, Servo A, Haltia M, Wahlström T, Valtonen S : Intracranial hemangiopericytoma : radiology, surgery, radiotherapy, and outcome in 21 patients. Surg Neurol 23 : 227-236, 1985 https://doi.org/10.1016/0090-3019(85)90087-4
  9. Kashiwazaki D, Hida K, Yano S, Seki T, Iwasaki Y : Subpial hemangiopericytoma with marked extramedullary growth : case report. Neurosurgery 61 : E1336-E1337; discussion E1337, 2007 https://doi.org/10.1227/01.neu.0000306116.93291.94
  10. Kruse F Jr : Hemangiopericytoma of the meniges (angioblastic meningioma of Cushing and Eisenhardt). Clinico-pathologic aspects and follow-up studies in 8 cases. Neurology 11 : 771-777, 1961 https://doi.org/10.1212/WNL.11.9.771
  11. Mena H, Ribas JL, Pezeshkpour GH, Cowan DN, Parisi JE : Hemangiopericytoma of the central nervous system : a review of 94 cases. Hum Pathol 22 : 84-91, 1991 https://doi.org/10.1016/0046-8177(91)90067-Y
  12. Moscovici S, Ramirez-DeNoriega F, Fellig Y, Rosenthal G, Cohen JE, Itshayek E : Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root : a case report and literature review. Spine (Phila Pa 1976) 36 : E1534-E1539, 2011 https://doi.org/10.1097/BRS.0b013e31822dddf4
  13. Osborne DR, Dubois P, Drayer B, Sage M, Burger P, Heinz ER : Primary intracranial meningeal and spinal hemangiopericytoma : radiologic manifestations. AJNR Am J Neuroradiol 2 : 69-74, 1981
  14. Pitlyk PJ, Dockery MB, Miller RH : Hemangiopericytoma of the spinal cord : report of three cases. Neurology 15 : 649-653, 1965 https://doi.org/10.1212/WNL.15.7.649
  15. Ross JS, Brant-Zawadzki M, Moore KR, Crim J, Chen MZ, Katzman GL : Diagnostic imaging : Spine, ed 1. Utah : Amirsys, 2004, ppIV.1.82-85
  16. Soyuer S, Chang EL, Selek U, McCutcheon IE, Maor MH : Intracranial meningeal hemangiopericytoma : the role of radiotherapy : report of 29 cases and review of the literature. Cancer 100 : 1491-1497, 2004 https://doi.org/10.1002/cncr.20109

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