Sacro-anterior haemangiopericytoma: a case report

Abstract

Haemangiopericytoma (HPC) is a rare vascular tumor with borderline malignancy, considerable histological variability, and unpredictable clinical and biological behavior. HPC can present a diagnostic challenge because of its indeterminate clinical, radiological, and pathological features. HPC generally presents in adulthood and is equally frequent in both sexes. HPC can arise in any site in the body as a slowly growing and painless mass. The precise cell type origin of HPC is uncertain. One third of HPCs occur in the head and neck areas. Exceptional cases of hemangioblastoma arising outside the head and neck areas have been reported, but little is known about their clinicopathologic and immunohistochemical features. This study reports on a case of a large sacro-anterior HPC in a 65-year-old male.

Keywords: Sacro-anterior; haemangiopericytoma (HPC); soft tissue tumor.

Figure 1

Abdominal CT: two pre-operation images of the abdomen. From the images, we can observe a large quasi-circular tumor, which is about 10.7 cm × 8.1 cm in the sacro-anterior. The tumor is intensified asymmetrically and its boundary is clear. The surrounding fat gap of the tumor is clear and no lymph node was found. CT, computerized tomography.

Figure 2

These four images illustrate the pathology of the sacro-anterior tumor. (A-C) Cancer cells involves spindle cell or oval cell and there are pericyte in perivascular. Cancer cells growth-arranged by radialted, concentric or irregular (H&E staining ×10); (D) there are deckzelles which are rounded, ovate or fusiform in perivascular, there are mitotic index in some nuclear (H&E staining ×40).

Figure 3

Two chest CT images show HPC metastasis in the right lung. The larger metastatic tumor is located in the middle and lower lobe of the anterior basal segment. The tumor is approximately 1.8 cm × 1.1 cm with smooth morphology (A). The smaller tumor is about 0.5 cm × 0.6 cm (B). CT, computerized tomography; HPC, haemangiopericytoma.

Figure 4

Three abdominal CT images taken 6 months after the last cycle of EP chemotherapy showed no signs of HPC recurrence. CT, computerized tomography; HPC, haemangiopericytoma.