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1.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318263

RESUMO

Sinonasal glomangiopericytoma is a rare sinonasal tumour accounting for less than. 5% of all sinonasal tumours. This tumour often presents as another, more common type of vascular lesion and is similarly prone to haemorrhage. The optimal treatment includes complete surgical resection. We, herein, present two such cases adding to the world literature of this rare tumour.


Assuntos
Seio Etmoidal/diagnóstico por imagem , Hemangiopericitoma/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Endoscopia , Seio Etmoidal/patologia , Seio Etmoidal/cirurgia , Feminino , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Seio Esfenoidal/patologia , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X
2.
Medicine (Baltimore) ; 99(31): e21605, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756216

RESUMO

INTRODUCTION: A meningeal hemangiopericytoma (MHPC) is an aggressive tumor characterized by a high rate of local recurrence and late distant metastasis. The objective of this study was to share our experience with the treatment of a MHPC and how to distinguish this tumor from a meningioma. PATIENT CONCERNS: A 62-year-old woman presented with symptoms of hypomnesia, hyperopia, and double vision for 1 month. Complete tumor excision was performed 6 years before. A biopsy sample was diagnosed as an atypical meningioma. DIAGNOSIS: MHPC with late delayed hepatic metastasis. INTERVENTION: Hepatic resection was performed initially, followed by secondary neurosurgery for complete excision of the bilateral frontal lesion 1 month later. OUTCOME: Based on the tumor pathology and consensus of oncologic surgeons, radiation therapy was initiated. Adjuvant therapy was well-tolerated and the patient remained recurrence-free at 6 months after surgery. CONCLUSION: Here, we report a case of local brain tumor recurrence and multiple hepatic metastases from a MHPC. Craniotomy combined with radical metastasectomy may be useful in such cases. Detailed immunohistochemical staining is helpful to distinguish a MHPC from a meningioma. Long-term follow-up is recommended.


Assuntos
Hemangiopericitoma/patologia , Neoplasias Hepáticas/secundário , Neoplasias Meníngeas/patologia , Feminino , Hemangiopericitoma/cirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Neoplasias Meníngeas/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia
3.
Brain Tumor Pathol ; 37(4): 165-170, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32740753

RESUMO

Solitary fibrous tumor/hemangiopericytoma is a mesenchymal tumor that originates from a common NAB2-STAT6 fusion gene and is known to very rarely demonstrate dedifferentiation in the pattern of local recurrence or distant metastasis. Here we describe for the first time a rare case of intracranial dedifferentiated solitary fibrous tumor/hemangiopericytoma with osteosarcoma components that developed in an 84-year-old man after frequent gamma knife radiosurgery over a 14-year period. We performed tumor-debulking and gamma knife radiosurgery, but unfortunately the patient died shortly after the development of dedifferentiation. There is no established treatment for dedifferentiated cases due to the rare histology and limited published data, and therefore further accumulation of histological and genetic profiles is necessary to develop novel target gene therapies.


Assuntos
Neoplasias Encefálicas/patologia , Desdiferenciação Celular , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Segunda Neoplasia Primária , Osteossarcoma/patologia , Tumores Fibrosos Solitários/patologia , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/cirurgia , Procedimentos Cirúrgicos de Citorredução , Progressão da Doença , Evolução Fatal , Fusão Gênica , Hemangiopericitoma/genética , Humanos , Masculino , Procedimentos Neurocirúrgicos , Osteossarcoma/genética , Osteossarcoma/cirurgia , Radiocirurgia , Doenças Raras , Proteínas Repressoras/genética , Fator de Transcrição STAT6/genética , Tumores Fibrosos Solitários/genética , Tumores Fibrosos Solitários/cirurgia
4.
World Neurosurg ; 139: 318-321, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32348892

RESUMO

A 37-year-old man presented with a 7-year history of low back pain. Magnetic resonance imaging revealed an intradural mass involving L5 vertebra impairment at the level of L4-L5. A L4-S1 laminectomy was performed. Pathology suggested the diagnosis of Solitary Fibrous Tumor/Hemangiopericytoma (SFT/HPCs). Unlike other spinal cord SFT/HPCs in lumbar area, we firstly reported the case with invasive growth and bone structure impairment. The patient had a good prognosis after 3-year follow-up. Complete resection should be achieved to reduce the recurrence.


Assuntos
Cauda Equina/patologia , Hemangiopericitoma/patologia , Neoplasias do Sistema Nervoso Periférico/patologia , Tumores Fibrosos Solitários/patologia , Adulto , Cauda Equina/cirurgia , Hemangiopericitoma/cirurgia , Humanos , Laminectomia , Masculino , Neoplasias do Sistema Nervoso Periférico/cirurgia , Tumores Fibrosos Solitários/cirurgia
5.
Medicine (Baltimore) ; 99(13): e19651, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221091

RESUMO

RATIONALE: Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are rare spindle cell tumors of mesenchymal origin that include benign and malignant neoplasms. PATIENT CONCERNS: We present a 66-year-old male with a 5-year history of headache and dizziness, with left progressive sensorineural hearing loss over 1 month. DIAGNOSES: WHO grade II SFT/HPC originating from the internal auditory canal in the left cerebellopontine angle. INTERVENTIONS: surgical resection. OUTCOMES: No local recurrence or metastases were observed in the follow-up 3 months after the surgery. LESSONS: Intracranial SFTs/HPCs are rare mesenchymal neoplasms that are challenging to manage. If the imaging characteristics of tumor are not typical, clinicians should depend on tissue biopsy and immunohistochemistry to make a definitive diagnosis.


Assuntos
Neoplasias Cerebelares/patologia , Ângulo Cerebelopontino/patologia , Hemangiopericitoma/patologia , Tumores Fibrosos Solitários/patologia , Idoso , Neoplasias Cerebelares/diagnóstico , Neoplasias Cerebelares/cirurgia , Diagnóstico Diferencial , Tontura/etiologia , Cefaleia/etiologia , Perda Auditiva/etiologia , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/cirurgia , Humanos , Masculino , Gradação de Tumores , Neuroma Acústico/diagnóstico , Tumores Fibrosos Solitários/diagnóstico , Tumores Fibrosos Solitários/cirurgia
6.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 31(1): 14-23, ene.-feb. 2020. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-190368

RESUMO

Hemangiopericytoma and Solitary Fibrous Tumor are tumors with low incidence. They have a tendency to recur locally and to metastasize. The WHO integrated both tumors into a new entity but one of the pending issues is to demonstrate the effectiveness of surgery plus complementary radiotherapy (RT) and standardize the use of it. We reviewed the data from 10 years. We assessed pathologic and radiologic characteristics. The operation records were evaluated to determine the features and extent of tumor resection. We compared the outcomes in patients using or not RT. The mean follow-up was 74.8 months, with a range of 12 and 210 months. The population included 3 males (30%) and 7 females (70%). The most common location was brain convexity (30%), the remaining were cervical and lumbar spine, sacrum, intraventricular, torcular, sphenoid ridge and intraorbital. Postoperative external beam radiotherapy was delivered in 7 patients (70%), the criteria were a partial resection or WHO II and III histological grades.2 patients developed local recurrences at 12 and 19 months after initial surgery.1 patient underwent 2 surgeries, and the other, 4 surgeries. The mean recurrence free survival rate was 15.5 months. Distant metastases were found in 4 PATIENTS: 3 of the 10 patients died. Five-year overall survival rate was 66% and mean overall survival was 76 months. A safe and complete resection in the first surgery is the most important prognostic factor.complementary RT can be helpful, even in cases of complete resection in WHO low-grade


El hemangiopericitoma y el tumor fibroso solitario son enfermedades del sistema nervioso central (SNC) con una incidencia baja. Estos tumores también pueden tener algunas características como una tendencia a recurrir localmente y hacer metástasis. La OMS, en su última clasificación de tumores del SNC, integró ambos tumores en una nueva entidad: tumor fibroso solitario/hemangiopericitoma (SFT/HPC), pero uno de los problemas actuales pendientes es demostrar la efectividad de la cirugía y la radioterapia (RT) complementaria, y estandarizar el uso de la misma. Revisamos todos los datos clínicos de nuestro hospital en un período de 10 años, y encontramos 10 pacientes con SFT/HPC. Se evaluaron los tamaños de los tumores, las ubicaciones y las características radiológicas. Los registros quirúrgicos de cada paciente se evaluaron para determinar las características macroscópicas y el alcance de la resección del tumor (EOR). También comparamos los resultados en los pacientes que utilizan o no RT como tratamiento complementario. El seguimiento medio fue de 74,8 meses, con un rango de 12 y 210 meses. La población incluía 3 varones (30%) y 7 mujeres (70%). La localización más frecuente fue la convexidad cerebral (30%). Las distribuciones de las localizaciones restantes del tumor fueron columna cervical y lumbar, sacro, intraventricular, torcular, ala esfenoidal e intraorbitario. La radioterapia postoperatoria (EBRT) se administró en 7 pacientes (70%), los criterios para tratarlos fueron una resección parcial o un grado histológico de la OMS II y III. Dos pacientes desarrollaron recidivas locales a los 12 y 19 meses después de la cirugía inicial. Un paciente se sometió a 2 cirugías, y el otro a 4 cirugías. La tasa media de supervivencia libre de recidiva (RFS) fue de 15,5 meses. Se encontraron metástasis a distancia en 4 pacientes durante el período de seguimiento. Tres de los 10 pacientes fallecieron durante el período de seguimiento. La tasa de supervivencia general a 5 años fue del 66%, y la supervivencia media global fue de 76 meses. Una resección segura y completa en la primera cirugía es el factor pronóstico más importante. Consideramos que la RT complementaria puede ser útil, incluso en casos de resección completa en SFT/HPC de bajo grado. Sería interesante definir previamente la diferenciación entre el SFT/HPC y los meningiomas para las estrategias de tratamiento


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Hemangiopericitoma/radioterapia , Hemangiopericitoma/cirurgia , Neoplasias do Sistema Nervoso Central/radioterapia , Neoplasias do Sistema Nervoso Central/cirurgia , Taxa de Sobrevida , Estudos Retrospectivos , Hemangiopericitoma/diagnóstico por imagem , Eletrofisiologia/métodos , Hemangiopericitoma/patologia , Diagnóstico Diferencial , Período Pós-Operatório
7.
AJNR Am J Neuroradiol ; 41(1): 155-159, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31806599

RESUMO

Glomangiopericytoma is a rare sinonasal mesenchymal tumor of borderline or low malignant potential. We reviewed the CT and MR imaging findings of head and neck glomangiopericytoma via a retrospective case series study and systematic review. Our study revealed that glomangiopericytoma is a well-defined lobulated avidly enhancing soft-tissue mass with erosive bony remodeling that is most commonly found in the sinonasal cavity. Typically, it is hyperintense on T2-weighted images with vascular signal voids, has a high mean ADC value, and a wash-in and washout pattern on dynamic contrast-enhanced MR imaging. Although the CT findings are nonspecific, typical MR imaging findings, including those on the ADC map and dynamic contrast-enhanced MR imaging, may be helpful for differentiating glomangiopericytomas from other hypervascular tumors in the head and neck.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Hemangiopericitoma/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Hemangiopericitoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/patologia , Estudos Retrospectivos
8.
Hum Pathol ; 95: 113-136, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31669060

RESUMO

Hemangiopericytoma and fibrosarcoma represented at one time two of the most common diagnoses in soft tissue pathology. Both terms are now largely extinct. This article will review the clinicopathologic, immunohistochemical and molecular genetic advances that have led to these changes, and review the pathologic features of a select group of soft tissue tumors previously classified as hemangiopericytoma or fibrosarcoma.


Assuntos
Fibrossarcoma/patologia , Hemangiopericitoma/patologia , Imuno-Histoquímica , Patologia Molecular , Neoplasias de Tecidos Moles/patologia , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/história , Difusão de Inovações , Fibrossarcoma/química , Fibrossarcoma/genética , Fibrossarcoma/história , Predisposição Genética para Doença , Hemangiopericitoma/química , Hemangiopericitoma/genética , Hemangiopericitoma/história , História do Século XX , História do Século XXI , Humanos , Imuno-Histoquímica/história , Imuno-Histoquímica/tendências , Patologia Molecular/história , Patologia Molecular/tendências , Fenótipo , Valor Preditivo dos Testes , Neoplasias de Tecidos Moles/química , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/história
9.
Medicine (Baltimore) ; 98(47): e17888, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764783

RESUMO

RATIONALE: Hemangiopericytoma (HPC) is a rare pediatric neoplasm with a high risk of bleeding, aggressive growth and high early relapse rates. Surgical excision remains the mainstream treatment, while the functions of chemotherapy and radiotherapy remain controversial. In particular, an infantile giant extracranial HPC located in the forehead has never been reported. PATIENT CONCERNS: A 3-day-old girl was delivered normally with a giant tumor localized mainly in the right frontal region. The surface of the mass was filled with vascularity. DIAGNOSIS: According to the results of imaging and pathological examinations, the diagnosis was HPC grade II. INTERVENTIONS: Gross total resection of the tumor and the invading partial frontal bone followed by skin scalp reconstruction was carried out without any blood transfusion. OUTCOMES: No recurrence was identified during 5 years of follow-up. And better outcomes can be achieved without adjuvant therapy. LESSONS: Multimodality imaging and a collaborative multidisciplinary approach are indispensable for the successful surgical management of infantile HPC, especially for giant tumors and their potential risk of life-threatening bleeding. Gross total resection is the optimal option for infantile HPC, and even without adjuvant therapy, it achieves better outcomes.


Assuntos
Neoplasias de Cabeça e Pescoço , Hemangiopericitoma , Neoplasias de Tecidos Moles , Pré-Escolar , Feminino , Seguimentos , Testa , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Humanos , Recém-Nascido , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Fatores de Tempo , Carga Tumoral
11.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(4): 512-516, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31484614

RESUMO

To study the clinicopathologic characteristics,immunohistochemical features,differential diagnosis,and prognosis of solitary fibrous tumours(SFT)/hemangiopericytomas(HPC)in the maters(meninx). Methods A series of 7 cases previously diagnosed as SFT/HPC at the Department of Pathology,Peking Union Medical College Hospital,during the period from 2008 to 2018 were analyzed for clinical data,histopathology,and immunohistochemical findings.The patients were followed up and the relevant literatures were reviewed. Results These seven patients included two males and 5 females aged 22 to 77 years(mean,49 years).Headache was the most common symptom.The magnetic resonance imaging of SFT/HPC showed irregularly contoured masses and dural tail sign was observed at the periphery of the lesion in 4 cases.The major axis of the tumor ranged from 1.8 cm to 10 cm(mean,4 cm).The tumors were located in the mater in 6 cases and in the spinal meninx in 1 case.The tumors were surgically removed in all cases.Under light microscope,the tumors were formed by long round,oval or spindle cells,with rich branching vascular pattern and varying quantity of collagenous fibers bands in both sparse areas and dense areas.According the WHO classification,2 cases were in WHO grade Ⅰ,2 cases in WHO grade Ⅱ,and 3 cases in WHO grade Ⅲ.Immunohistochemistry of the paraffin-embedded tissues in all cases showed positive immunoreativity for CD34 and vimentin in all seven cases,along with positive signal transducer and activator of transcription 6 in 4 cases,negative epithelial membrane antigen and S-100 in 7 cases,and negative progestational hormone and somatostatin receptor 2 in 6 cases.The Ki-67 index ranged from 1% to 15%.Five patients with follow-up data(including 1 current case)were alive,while 2 patients were lost to follow-up. Conclusions The SFT/HPC are rare in the maters(meninx)and is clinically difficult to be differentiated from other meningioma.The combination of CD34 and signal transducer and activator of transcription 6 helps to diagnose this disease.


Assuntos
Hemangiopericitoma/diagnóstico , Meninges/patologia , Tumores Fibrosos Solitários/diagnóstico , Adulto , Idoso , Antígenos CD34/metabolismo , Diagnóstico Diferencial , Feminino , Hemangiopericitoma/patologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Prognóstico , Fator de Transcrição STAT6/metabolismo , Tumores Fibrosos Solitários/patologia , Adulto Jovem
12.
Ann Ital Chir ; 82019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31366738

RESUMO

BACKGROUND: Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm affecting soft tissues with a not well defined biological behavior. SFT occurs mostly in the pleura and the thorax, while extra-thoracic localization is uncommon and abdominal localization is very rare. Histologically, SFT is a well defined mass with splindle-cell proliferation in collagenous matrix with staghorn vascular network and CD34 reactive. CASE REPORT: A 64 years-old man with a history of recurrent gastric cancer previously treated with total gastrectomy, was admitted with contrast enhanced CT-scan diagnosis of a well demarcated oval mass of 4.8 cm with microcysts, vascularized in the arterial phase and with wash out in the tardive phase, located in the peritoneal side of right rectus abdominis muscle, suspected for metastatic gastric tumor. The patient underwent minilaparotomy and en-bloc excision of the lesion. Histologically the tumor was characterized by a hemangiopericitoma like growth pattern and the immunostaining was positive to CD34, CD99, BCL-2 and Vimentin. The definitive diagnosis was SFT with a proliferation index (Ki-67/MIB-1) <3%. In our case, chemotherapy was not indicated. At the 6-month follow-up, the patient is in good clinical conditions with no recurrence or metastasis. CONCLUSIONS: We reported a rare case of primitive SFT located in peritoneal side of the of right rectus abdominis muscle treated surgically, in a patient previously affected by gastric adenocarcinoma. In this case, SFT showed a benign behaviour during a short term follow-up. Dimensional pattern, histopathological features and curative surgery remain the most important indicators of clinical outcome. KEY WORDS: Abdominal wall, Hemangiopericitoma, SFT, Solitary fibrous tumorSpindle cell.


Assuntos
Neoplasias Abdominais/cirurgia , Segunda Neoplasia Primária/cirurgia , Reto do Abdome/patologia , Tumores Fibrosos Solitários/cirurgia , Neoplasias Abdominais/química , Neoplasias Abdominais/diagnóstico , Neoplasias Abdominais/patologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/secundário , Biomarcadores Tumorais , Diagnóstico Diferencial , Gastrectomia , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/patologia , Tumores Fibrosos Solitários/química , Tumores Fibrosos Solitários/diagnóstico , Tumores Fibrosos Solitários/patologia , Neoplasias Gástricas/cirurgia
13.
World Neurosurg ; 130: e383-e392, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31233926

RESUMO

OBJECTIVE: Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma exhibit similar radiographic features; however, they differ in their prognoses. Preoperative differentiation between them is important for determining the treatment and follow-up plan. The aim of this study was to determine the factors that can be used to differentiate SFT/HPC from meningioma and World Health Organization (WHO) grade I from grade II meningioma. METHODS: The analysis included 84 cases: 5 of SFT/HPC, 72 of WHO grade I meningioma, and 7 of WHO grade II meningioma. Clinical characteristics and conventional magnetic resonance imaging, perfusion magnetic resonance imaging, and magnetic resonance spectroscopy (MRS) LCModel parameters were evaluated via multivariate logistic regression analysis to identify the factors that distinguish SFT/HPC from meningioma. RESULTS: Patients with SFT/HPC were mostly men and were younger than those with meningioma. The percentage of T2-weighted images in meningioma was greater than that in SFT/HPC. There were significant differences between SFT/HPC and meningioma in levels of glutamate, phosphocholine, myo-inositol, or glycerophosphocholine + phosphocholine derived from long echo-time MRS, and myo-inositol derived from short echo-time MRS. Stepwise logistic regression analysis revealed that the age of <45 years and myo-inositol in short echo-time MRS of ≧6.347 were associated with a diagnosis of SFT/HPC with high sensitivity and specificity. However, no factors were found that differentiated WHO grade I meningioma from WHO grade II meningioma. CONCLUSIONS: Age and myo-inositol level calculated from MRS are useful factors for distinguishing SFT/HPC from meningioma preoperatively.


Assuntos
Hemangiopericitoma/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Tumores Fibrosos Solitários/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Diagnóstico Diferencial , Feminino , Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/patologia , Humanos , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/patologia , Meningioma/diagnóstico por imagem , Meningioma/patologia , Pessoa de Meia-Idade , Gradação de Tumores , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/patologia , Adulto Jovem
14.
J Neuroradiol ; 46(5): 281-287, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31226327

RESUMO

PURPOSE: To assess whether a machine-learning model based on texture analysis (TA) could yield a more accurate diagnosis in differentiating malignant haemangiopericytoma (HPC) from angiomatous meningioma (AM). MATERIALS AND METHODS: Sixty-seven pathologically confirmed cases, including 24 malignant HPCs and 43 AMs between May 2013 and September 2017 were retrospectively reviewed. In each case, 498 radiomic features, including 12 clinical features and 486 texture features from MRI sequences (T2-FLAIR, DWI and enhanced T1WI), were extracted. Three neuroradiologists independently made diagnoses by vision. Four Support Vector Machine (SVM) classifiers were built, one based on clinical features and three based on texture features from three MRI sequences after feature selection. The diagnostic abilities of these classifiers and three neuroradiologists were evaluated by receiver operating characteristic (ROC) analysis. RESULTS: Malignant HPCs were found to have larger sizes, slighter degrees of peritumoural oedema compared with AMs (P<0.05), and more serpentine-like vessels. The AUC of the enhanced T1WI-based classifier was 0.90, significantly higher than that of T2-FLAIR-based or DWI-based classifiers (0.77 and 0.73). The AUC of the SVM classifier based on clinical features was 0.66, slightly but not significantly lower than the performances of 3 neuroradiologists (AUC=0.69, 0.70 and 0.73). CONCLUSION: Machine-learning models based on clinical features alone could not provide a better diagnostic performance than that of radiologists. The SVM classifier built by texture features extracted from enhanced T1WI is a promising tool to differentiate malignant HPC from AM before surgery.


Assuntos
Diagnóstico por Computador/métodos , Hemangiopericitoma/diagnóstico por imagem , Aprendizado de Máquina , Imageamento por Ressonância Magnética/métodos , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neurorradiografia/métodos , Adulto , Feminino , Hemangiopericitoma/patologia , Humanos , Masculino , Neoplasias Meníngeas/patologia , Meningioma/patologia , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Estudos Retrospectivos , Sensibilidade e Especificidade
15.
J Neurooncol ; 143(3): 457-464, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31054100

RESUMO

BACKGROUND: Prior studies have highlighted infratentorial tumor location as a prognostic factor for solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) of the central nervous system (CNS), and spinal location is considered a positive prognostic factor for other tumors of the CNS. While SFT/HPC of the CNS is known to frequently arise from the spinal meninges, there are no case series that report outcomes for spinally located CNS tumors, and their prognosis in relation to intracranial and other CNS-located tumors is unknown. OBJECTIVE: To investigate outcomes for patients with SFT/HPC of the spinal meninges. METHODS: The Surveillance, Epidemiology, and End-Results Program was used to identify patients with SFT/HPC within the CNS from 1993-2015. We retrospectively analyzed the relationship between tumor location (spinal vs. Brain and other CNS) and survival. RESULTS: We identified 551 cases of CNS SFT/HPC, 64 (11.6%) of which were primary tumors of the spinal meninges. Spinal tumors were more likely than brain and other CNS tumors to be SFT vs. HPC (37.5 vs. 12%, p < 0.001), benign (42.2 vs. 20.3%, p < 0.001), and less than 5 cm (53.1 vs. 35.7%, p < 0.001). The 10-year survival rates for spinal and brain/other CNS tumors were 85 and 58%, respectively. Median survival time was significantly longer for spinal tumors (median survival not reached vs. 138 months, p = 0.03, HR = 0.41 [95% CI 0.18-0.94]). On multivariable analysis, spinal tumor location was associated with improved survival over tumors located in the brain and other CNS (HR = 0.36 [95% CI 0.15-0.89], p = 0.03). CONCLUSION: Spinal tumor location is associated with improved survival in patients with SFT/HPC of the CNS. Larger institutional studies are necessary to characterize the relationship between tumor location and other relevant factors such as presentation and amenability to gross-total resection and adjuvant radiotherapy. Future studies exploring optimal management of spinally located tumors are also needed.


Assuntos
Hemangiopericitoma/mortalidade , Tumores Fibrosos Solitários/mortalidade , Neoplasias da Coluna Vertebral/mortalidade , Neoplasias da Coluna Vertebral/patologia , Feminino , Seguimentos , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Programa de SEER , Tumores Fibrosos Solitários/patologia , Tumores Fibrosos Solitários/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Taxa de Sobrevida
17.
J Am Anim Hosp Assoc ; 55(4): 194-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31099606

RESUMO

This retrospective study evaluated the postoperative outcome and clinical parameters associated with prognosis in 167 client-owned dogs with 167 hemangiopericytomas. Parameters that were reviewed for an association with long-term outcome included signalment, clinical history, results of staging tests, tumor and surgical variables, and administration of adjunctive therapy. History of previous surgery, type of surgery performed, status of surgical margins, tumor location, and whether adjunctive therapy was performed were associated with tumor recurrence. The distal forelimb was the most common location reported overall (46/167 [27.5%]). Dogs with tumors located at the tail/perineum had the fastest recurrence rate, with a median disease-free interval of ∼16 mo (505 days). Tumor grade alone was not associated with recurrence (P = .069), but when analyzing tumor grade and margin, low-grade tumors with dirty margins had a significantly shorter time to recurrence than low-grade tumors with either clean or narrow margins. Tumor location should be considered when assessing the treatment plan and follow-up recommendations for any hemangiopericytomas. Aggressive initial surgical treatment is recommended when possible to reduce the chance of local tumor recurrence.


Assuntos
Doenças do Cão/cirurgia , Hemangiopericitoma/veterinária , Neoplasias Esplênicas/veterinária , Animais , Terapia Combinada , Intervalo Livre de Doença , Doenças do Cão/patologia , Cães , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Estudos Retrospectivos , Esplenectomia/veterinária , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Resultado do Tratamento
18.
Neuropathology ; 39(2): 141-146, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30864263

RESUMO

This report describes the clinicopathological findings of a solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) of the central nervous system in a 59-year-old man with space-occupying lesions on both the left anterior basicranial and on the top tail of falx cerebri. The tumor showed small quantities of solid papillary areas and a prominent papillary structure, where atypical cells were compactly arranged along the fibrovascular core. The tumor cells of both components showed nuclear relocalization of the signal transducer and activator of transcription 6 protein, with very high specificity and sensitivity for the diagnosis of SFT/HPC. In the literature, only three cases of SFTs with a papillary pattern have been reported, but this case showed a complete papillary pattern. "Papillary" SFT/HPC is a rare morphological variant of SFTs/HPCs, and its differential diagnosis among intracranial tumors is an important factor which clinicians should bear in mind during diagnosis.


Assuntos
Neoplasias Encefálicas/patologia , Hemangiopericitoma/patologia , Tumores Fibrosos Solitários/patologia , Neoplasias Encefálicas/metabolismo , Hemangiopericitoma/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Fator de Transcrição STAT6/metabolismo , Tumores Fibrosos Solitários/metabolismo
19.
Radiographics ; 39(2): 468-490, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844353

RESUMO

While intradural extramedullary spinal disease varies widely, identification of tumors in this location and their radiologic manifestations greatly facilitates narrowing of the diagnostic considerations. Meningioma and schwannoma are the two most common intradural extramedullary tumors, and both are associated with neurofibromatosis. Meningiomas are most common in the thoracic spine and show a strong female predilection and a clinical manifestation related to compression of the spinal cord or nerve roots. Schwannomas typically are associated with radicular pain and other sensory symptoms. Melanotic schwannoma frequently shows T1 hyperintensity at MRI related to the presence of paramagnetic free radicals in melanin. Neurofibroma, known for its T2 hyperintensity, frequently involves the cervical spine, where it may make surgical resection challenging. Less commonly, malignant peripheral nerve sheath tumor commonly mimics the imaging appearance of a schwannoma but has decidedly more aggressive biologic behavior. In the cauda equina, myxopapillary ependymoma and paraganglioma are believed to arise from the filum terminale and have characteristic imaging manifestations based on their underlying pathologic features. Recent identification of a common genetic marker has led to reclassification of what had previously been regarded as separate tumors and are now known as solitary fibrous tumor/hemangiopericytoma. In the proper clinical setting, the presence of nodular intradural enhancement strongly suggests the presence of leptomeningeal metastatic disease, even when results of cerebrospinal fluid analysis are negative. This article highlights the characteristic neuroimaging manifestations of these neoplasms, with emphasis on radiologic-pathologic correlation. See Illumination by Frazier .


Assuntos
Neuroimagem/métodos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Meios de Contraste , Ependimoma/diagnóstico por imagem , Ependimoma/patologia , Feminino , Gadolínio , Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/secundário , Meningioma/diagnóstico por imagem , Meningioma/patologia , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurofibroma/diagnóstico por imagem , Neurofibroma/patologia , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Neoplasias da Coluna Vertebral/patologia
20.
Clin Nucl Med ; 44(4): e305-e307, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30762828

RESUMO

We report the case of a 50-year-old man, with previous history of grade 3 intracranial hemangiopericytoma with initial complete surgical resection, addressed for local recurrence. Surgical revision performed 18 months after initial surgery allowed only partial resection, leaving residual disease along the optic nerve. Complementary radiotherapy with proton was decided. F-FDG PET/CT and F-choline PET/CT were both performed for treatment planning. F-FDG PET showed no uptake of the residual tumor, whereas F-choline depicted highly metabolic residual disease uptake with excellent delineation of local recurrence. F-choline PET/CT appears as a useful PET tracer for hemagiopericytoma imaging.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Colina/análogos & derivados , Hemangiopericitoma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias Encefálicas/patologia , Hemangiopericitoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Recidiva
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