Analysis The Diagnosis And Treatment Of Eight Intracranial Hemangiopericytomas

Objective: To analysis and discuss the clinical and imaging presentation,pathological feature,treatment and prognosis of intracranial hemangiopericytoma.Improve the level of awareness,diagnosis and treatment of intracranial hemangiopericytoma.Method: Retrospectively analyzing the intracranial hemangiopericytoma patients who have been diagnosed as intracranial hemangiopericytoma with pathological examination admitted to neurosurgery department of our hospital from 2005 to 2015.Results: Ten operations were performed in 8 patients.Two of the patients were men,six of the patients were women,and male female ratio is 1:3.The patient's ages ranged from 47 to 85 years(mean 63 years).Seven patients' clinical manifestations were headache.Three patients' balance disturbance,one of the three patients is both lower extremities ache,one of the three patients is hearing disturbance.One patient is both upper extremities numbness.One patient is visual disturbance.One patient is hypomnesia and clouding of consciousness.One patient has no clinical manifestation,we found out the tumor just because of CT examination after head injury.All patients had CT and MRI plain and enhancement scanning.Three patients had tumors in the parietal lobe region,one patient had tumor in the occipital lobe region,one patient had tumor in the lateral fissure region,one patient had tumor in the saddle area region,one patient had tumor in the cerebellopontine angle region,one patient had tumors in the right lateral cerebral ventricle and right occipitals region.The shapes of all tumors were irregular.Five of eight patients have been diagnosed as meningioma.One has been diagnosed as malignant meningioma.One has been diagnosed as intracranial lymphoma.One has been diagnosed as hemangiopericytoma.All patients had surgical treatment.One tumor was resected as Simpson grade 0,three tumors were resected as Simpson grade 1,three tumors were resected as Simpson grade 2,one tumor was resected as Simpson grade 3.All patients have been diagnosed as intracranial hemangiopericytoma with pathological examination,immunohistochemical examination showed: vimentin showed expression in eight cases,epithelial membrane antigens showed no expression in eight cases,CD34 was expressed in 6 cases,proliferating cell nuclear antigen Ki-67 immunohistochemical staining was expressed in eight cased,about 5% expressed in 2 cases,5%-10% expressed in 1 case,10%-15% expressed in 5 cases.All patients' clinical manifestations took a turn for the better after surgery treatment.Follow-up was taken for all patients,the patient's follow-up time ranged from 1 to 5 years(mean 23 months).2 patients didn't received post-surgical adjuvant radiotherapy,6 patients received post-surgical adjuvant radiotherapy without any chemotherapy.Recurrence occurred in 2 patients,all of them are male,pathologic diagnosis is anaplastic hemangiopericytoma(WHO grade III),and the tumors all developed recurrence at the original site,no one developed recurrences at other site.They got a surgical treatment again.no one developed recurrences at other site.Conclusion:1?Given its rarity,hemangiopericytoma in the central nervous system has no certain clinical features,the diagnosis and differentiate of hemangiopericytoma remains a challenge.But on the imaging tumors always showed lobulated borders,necrosis or cystic degeneration,dura narrow-based,blood vessel flow void sign and osteolytic lesion.MRS or PET examination have a good effect for diagnosis and differentiate of hemangiopericytoma.2?The mainstay of treatment of hemangiopericytoma is surgical resection.Achieving radiotherapy during the first surgery could reduce the risk of recurrence and prolong survival.3?local and distant recurrences may occur after a prolonged disease-free interval,emphasizing the need for long-term follow-up.