Surgical treatment of hemangiopericytoma with intracanal and paravertebral growth. Clinical case

Abstract

Hemangiopericytoma can occur anywhere in the body where capillaries are located. However, most often this tumor is detected in the subcutaneous soft tissues, pelvic ring, lower limbs and retroperitoneal space [2]. Hemangiopericytoma rarely affects the central nervous system. Because of the rarity of the disease, the clinical features, treatment, and outcomes are poorly understood.

Patient M, 64 years old, male, applied to the polyclinic of the State University "Institute of Neurosurgery named after Acad. A.P. Romodanov of the National Academy of Medical Sciences of Ukraine" with complaints of pain in the thoracic spine with radiation to the left subscapular region of the body, numbness and weakness in the lower limbs. After an MRI, a diagnosis of a tumor of Th5-Th6 vertebrae was established. Given the presence of a spinal tumor in the patient with spinal cord compression, a decision was made to perform an operation to remove the tumor as a priority. After surgery, the patient's radicular pain and leg weakness immediately disappeared. CT was performed. The tumor was removed completely.

Hemangiopericytomas are aggressive neoplasms with a high recurrence rate and a tendency to metastasize. The recurrence rate of hemangiopericytoma ranges from 50 to 80%, and metastases - from 14 to 30%, but can be as high as 23-64%, which makes the treatment of this disease very difficult. Surgical intervention and postoperative irradiation in a dose of up to 60 Gy, based on the data of the literature review, significantly improves treatment outcomes and reduces the number of recurrences compared to surgery alone. Surgical resection of the tumor should be total, if possible, in cases when the tumor cannot be removed completely, it should be removed as subtotal as possible.