Intracranial Hemangiopericytoma in a 15 Year-old Child: Neuroimaging Features and Management Therapy
Mohamed Badri *
Department of Neurosurgery, Faculty of Medicine of Tunis, Tunis El Manar University, Burns and Trauma Center, 2013, Ben Arous, Tunisia
Cyrine Drissi
Department of Neuroradiology, Faculty of Medicine of Tunis, Tunis El Manar University, National Institute of Neurology, 1007 Bab Saadoun, Tunis, Tunisia
Sofiene Bouali
Department of Neurosurgery, Faculty of Medicine of Tunis, Tunis El Manar University, National Institute of Neurology, 1007 Bab Saadoun, Tunis, Tunisia
Asma Bouhoula
Department of Neurosurgery, Faculty of Medicine of Tunis, Tunis El Manar University, National Institute of Neurology, 1007 Bab Saadoun, Tunis, Tunisia
Hafedh Jemel
Department of Neurosurgery, Faculty of Medicine of Tunis, Tunis El Manar University, National Institute of Neurology, 1007 Bab Saadoun, Tunis, Tunisia
Zammel Ihsen
Department of Neurosurgery, Faculty of Medicine of Tunis, Tunis El Manar University, Burns and Trauma Center, 2013, Ben Arous, Tunisia
*Author to whom correspondence should be addressed.
Abstract
Introduction: Intracranial hemangiopericytoma (HPR) is a highly vascular tumors which is exceptional in children. They may present management difficulties in some cases.
Clinical Presentation: The authors report the case of a 15 year-old female presented with symptoms of increased intracranial pressure. Physical examination featured a frontal syndrome, a Broca’s aphasia, a grade 3 papilledema and a decreased visual acuity in her left eye. Radiological investigation including cranial CT scan and MRI displayed a large dural-based heterogeneous hemorrhagic tumor of the left frontal convexity. The patient underwent a total-gross resection of an extra-parenchymal hemorrhagic tumor through a large frontal craniotomy with no postoperative complications. Pathologic examination of the specimen and immuno-histochemistry concluded to an anaplastic HPR. Postoperative radiotherapy was performed without incidents. A local recurrence was diagnosed four months postoperatively and remained stable after additional radiotherapy.
Conclusion: Intracranial anaplastic HPR in children are rare. Imaging features are not specific and may mimics meningioma. Microneurosurgery with adjuvant radiotherapy is required in the management of these aggressive tumors.
Keywords: Hemangiopericytoma, child, surgery, radiotherapy, intracranial, MRI