A RARE CASE OF MENINGEAL HEMANGIOPERICYTOMA ACCOMPANIED WITH INTRAOPERATIVE BLOOD LOSS

Abstract

Introduction: Meningeal hemangiopericytomas are rare tumors of the meninges which are aggressive and pathohistologically belong to solitary fibrous tumors of the dura. The tumor might be found throughout the entire CNS, usually superficially and closely related to the meninges. Important characteristic is that they have a strong tendency for local recurrence and also are associated with extra cranial metastasis. Case Report: In this study, we present a case of 71 years old man primarily asymptomatic, who presented with sudden symptoms of headache, dizziness, and loss of consciousness. He was immediately transferred to the department of urgent medicine where primary computer tomography (CT) scan was done. For a certain diagnosis to be established magnetic resonance imaging (MRI) was secondly done. MRI showed extra axial, solitary, supratentorial masses, lobulated in contour, highly vascular with a tendency to erode the nearby parietal bone. In T1 and T2 waited images it was isointense to grey matter. In Diffusion waited images (DWI) this tumor showed intermediate restricted diffusion (less than meningioma). After intravenous application of contrast medium – gadolinium, it shows vivid enhancement, heterogeneous, and a dural tail sign was seen. Total surgical excision was done with the complication of intraoperative bleeding, and the diagnosis of meningeal hemangiopericytoma obtained on MRI was pathohistological confirmed. Conclusion: Meningeal hemangiopericytoma (HPC) are aggressive lesions with a tendency for extracranial metastasis, also this tumor has a tendency for high rates of recurrence, and is characterized with local aggressive behavior. On both CT and MRI modality distinguishing a hemangiopericytoma from a meningioma, sometimes can be difficult because of their similar appearance, but is important the interpretation to be adequate especially with MRI because of the need for pre-operative catheter embolization in order to prevent the intraoperative blood loss, and also adjuvant radiotherapy might be required to reduce the risk of local recurrence and distant metastasis