Combined therapy against recurrent and intracranial invasion of sinonasal hemangiopericytoma: A case report

Sinonasal hemangiopericytoma (HPC) is a soft tissue tumor of vascular origin. Open surgical methods and endoscopic techniques are considered the standard treatments for sinonasal HPC. However, local recurrences resulting from residual tumors are common. Adjuvant radiotherapy and chemotherapy have also been used to treat HPC, however, the number of studies which have investigated effective adjuvant treatments in the literature are limited. The current study reports a 42-year-old male with recurrent and intracranial invasion of sinonasal HPC, diagnosed in Xuanwu Hospital (Beijing, China). The patient underwent multiple surgeries to remove the tumors, however, no adjuvant therapy was adopted during this period and the tumors reoccurred within 1 year. On admittance to Tangshan People's Hospital (Tangshan, China), the patient presented with limited mouth opening and chewing ability, and hearing loss. Under observation using an electron microscope, HPC usually consists of spindle-shaped cells with elongated nuclei and displays characteristic staghorn-like vascular channels. In the present case, immunohistochemical studies were performed on paraffin-embedded sections of the tumor. The tumor cells expressed CD34, CD68(+/-), epithelial membrane antigen, CD31, -actin, desmin, CD99, S-100, B-cell lymphoma-2 and Ki-67 (30%), but were negative for creatine kinase. The patient was treated with intensity-modulated radiotherapy and adjuvant chemotherapy, which demonstrated efficacy. No recurrence and metastasis was observed at the 1 year follow-up subsequent to the combined therapy.