Intracranial hemangiopericytoma:: Treatment outcomes in a consecutive series

Objective: The purpose of this study was to analyse a series of patients harbouring an intracranial hemangiopericytoma (HPC) with respect to clinical presentation, treatment results and long-term follow-up outcomes. Patients and Methods: Clinical data were retrospectively obtained in a series of 12 patients who underwent microsurgical resection for HPC at two neurosurgical institutions between 1987 and 2004. Results: The main presenting symptoms in the seven men and five women (mean age 38 years) were headache in 50% and epileptic seizures in 33% of the patients. A Simpson grade I resection was achieved in seven patients (58%) and none of these patients developed local tumour recurrence after a mean follow-up period of 127 months (10.6 yrs). Only one of these patients received adjuvant radiotherapy. A recurrence of the HPC was observed in all patients (42%) who underwent subtotal tumour resection at first surgery (Simpson grade II or higher). Recurrences occurred after a mean period of 39 months (3.2 yrs) after primary surgery and were effectively controlled by surgical excision, radiotherapy and gamma knife radiosurgery. Two patients (17%) developed extraneural metastases which were treated by surgical excision, radiotherapy and salvage chemotherapy. Poly-chemotherapy was ineffective with respect to tumour control in this study. Conclusions: The study emphasises the importance of total resection of HPC, defined as a Simpson grade I removal, at first surgery. Adjuvant radiotherapy is recommended after subtotal tumour resections. A life-long vigilant follow-up of these patients is mandatory.