Multicentric hyaline-vascular Castleman's disease in the retroperitoneum

BACKGROUND:Castleman’s disease is a rare lymphoproliferative disease of unknown cause.Most multicentric cases described have been of the plasma-cell variety.This article presents a case of multicentric hyaline-vascular Castleman’s disease in the retroperitoneum with the ultrasonographic and computed tomography(CT)imaging manifestations. METHODS:During routine physical examination,a mass was detected in the left abdomen of a 53-year-old man with no signs or symptoms.The patient underwent ultrasoundguided aspiration biopsy and operative excision after laboratory examination,ultrasonography,and CT. RESULTS:Ultrasonography demonstrated a dominant hypoechogenic mass with hypervascularity in the retroperitoneum.CT detected a relatively homogenous enhanced lesion and several satellite nodules.After the mass and several lymph nodes were resected, histopathologic examination demonstrated a lymphocytepredominant infiltrate surrounding the germinal centres and extensive capillary proliferation,consistent with the hyaline-vascular type of Castleman’s disease.The patient received postoperative chemotherapy and remained free of recurrence 3 months later. CONCLUSION:Ultrasonography and contrast-enhanced CT can provide a positive differential diagnosis of hyalinevascular Castleman’s disease which is a kind of giant lymph node hyperplasia with hypervascularity.

Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults

Lymphangioma, a benign neoplasm of the lymphatic system, is common in children but rare in adults. Its clinical manifestations include abdominal pain, nausea, vomiting and a palpable mass. However, abdominal sonography or abdominal computed tomography （CT） scan can also incidentally reveal lymphangioma. A larger or symptomatic lymphangioma is treated with total resection to prevent recurrence, infection, torsion and enlargement. Although lymphangioma rarely becomes malignant, its prognosis is generally good. We report a cystic lymphangioma of the spleen and retroperitoneum, which was incidentally found in a 56-year-old man who was hospitalized due to a colon mass. Physical examination showed no specific findings. Abdominal CT revealed a 5.7 cm, non-enhanced multilobulated cystic mass with multiple sepia in the spleen and a 10 cm lobulated cystic mass in the paraaortic area. Splenectomy and retroperitoneal resection of the cystic mass were conducted. The endothelium of splenic and retroperitoneal cyst was immunohistochemically stained with D2-40 antibody. The patient was finally diagnosed with splenic cystic and retroperitoneal cavernous lymphangioma.

Angioarchitecture and CD133^+ tumor stem cell distribution in intracranial hemangiopericytoma A comparative study with meningioma

Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor （vWF） and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133＋ tumor cells were found to form tumor cell islands. A connection between vWF ^＋ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^＋ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected ＂floating＂ in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding.

Lipomatous hemangiopericytoma of the stomach:A case report and a review of literature

Lipomatous hemangiopericytomas(LHPCs) are rare soft-tissue tumors that are histologically characterized by hemangiopericytomatous vasculature and the presence of mature adipocytes.We present the clinicopathological features of a case of gastric LHPC in a 56-year-old female,along with a literature review.Endoscopy and endoscopic ultrasound showed a submucosal tumor 0.8 cm across in the greatest dimension in the lesser curvature side of the gastric antrum.Grossly,the well-defined mass had a solid and tan-white cut surface admixed with myxoid regions and yellowish areas.Histological examination revealed a submucosal well-circumscribed lesion composed of cellular nodules with the classic appearance of an hemangiopericytoma admixed with clusters and lobules of mature adipocytes.The ill-defined tumor cells had weakly eosinophilic cytoplasm and contained spindled nuclei with occasional small nucleoli.Nuclei atypia and mitoses were absent,and no cellular atypia,necrosis or vascular invasion was observed.Immunohistochemistry showed that the tumor cells were diffusely positive for CD34,CD99,and vimentin and were focally reactive for bcl-2.This is the first known report of an LHPC in the stomach.The patient was followed for 12 mo without any evidence of metastasis or recurrence.

Case Report： Myxoid Liposarcoma in Retroperitoneum

Liposarcoma is a malignant neoplasm of mesodermal origin, which among sarcomas, 10% to 20% are located in the retroperitoneum. The case presented shows a 50-year-old male patient who initially presented weight loss and abdominal pain in the left iliac fossa. A tumor mass of hardened consistency was palpated in virtually all the abdomen. An abdominal ultrasound and a computed tomography of the abdomen were performed and confirmed the tumor mass. An exploratory laparotomy was performed, with removal of bulky abdominal mass of greasy consistency. A histopathological study of the piece reported myxoid liposarcoma. Clinical and prognostic features, as well as oncologic outcomes, are well known in this group of patients. The patient has been in the outpatient clinic for 7 years without tumor recurrence. Computed tomography is the fundamental study for the diagnosis of imaging. The treatment of choice consists in an aggressive approach aiming the complete resection, which is a major predictor of local and distant recurrence and survival.

Meningeal Hemangiopericytoma: A Rare Intracranial Tumor—About a Case

Introduction: Hemangiopericytoma is a very rare vascular tumor, difficult to diagnose, often confused with a meningioma. Imaging is not very specific and the diagnostic certainty remains histological. Observation: We report a case of meningeal hemangiopericytoma in a 48-year-old patient with a history of active smoking and whose sister died of glioblastoma. He was brought to the emergency room for a fall, confusion, and tonic-clonic seizures. The diagnosis was suspected on imaging (CT and MRI, in front of a syndrome of right temporal intraventricular mass measured at 37 mm in diameter, centered on the choroid plexus, with perilesional vasogenic edema and posterior white commissure. There was homogeneous enhancement of the lesion after gadolinium injection. The diagnosis was confirmed by immunohistochemical study, which showed diffuse expression of STAT6 and partial labeling for CD34, without significant expression of SSTR2. Expression of neurofilament protein was also found in the brain parenchyma. Conclusion: Hemangiopericytoma is a rare tumor, characterized by its malignant potential, its high rate of recurrence and distant metastasis. The management is based on a total microsurgical resection followed by radiotherapy.

Clinical study and differential diagnosis of intracranial hemangiopericytomas

Objective Intracranial hemangiopericytomas (HPCs) were rare neoplasms with relatively high rates of recurrence and extracranial metastasis.The differential diagnoses from angiomatous meningiomas and solitary fibrous tumors(SFTs) are very important. This study aimes to reveal differences in the specific immunohistochemical features of HPCs,angiomatous meningiomas and SFTs by newly

A case of hemangiopericytoma of the soft palate with articulate disorder and dysphagia

We report a case of hemangiopericytoma of the soft palate of 60-year-old patient, who noticed a mass of the soft palate and experienced difficulty in speaking. We found a pediculate, hard, elastic mass measuring 38 mm （cross-sectional diameter）. Computed tomography （CT） scans and dynamic magnetic resonance imaging （MRI） confirmed irregularly shaped mass and revealed a heterogeneous internal composition, consistent with vascular tumors. We excised the tumor under general anesthesia. Histopathological diagnosis was based on positive immunoreactivity of CD99 and vimentin and weak, positive staining of CD34. Three and half years following tumor excision, there is no recurrence or metastasis.

Splenic hemangiopericytoma and serosal cavernous hemangiomatosis of the adjacent colon

A healthy 31-years-old man presented with a three-year history of abdominal discomfort. Radiological examinations revealed multifocal tumoral lesions in the spleen. The patient underwent splenectomy for differential diagnosis and treatment. During the operation, in addition to the splenic masses, there were also multiple milimetric purpuric-like lesions on the colonic serosal surfaces adjacent to the splenic hilus. One of them was excised. Histologic examination showed hemangiopericytoma of the spleen and cavernous hemangioma of the adjacent colon. This is the first report showing the close association of these two distinct lesions with vascular origin in the literature. Despite not having any apparent evidence, there may be a sequential relationship between the hemangiopericytoma of the spleen and cavernous hemangiomas.

Intracranial Hemangiopericytoma Focally Recurrent to the Pelvis

A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appeared anatomically distinct from the sacrum. This metastasis was found 10 years after the initial resection of his intracranial lesion. An abdominal resection was performed, and the patient recovered uneventfully. Final pathology and staining findings were consistent with metastatic hemangiopericytoma. Hemangiopericytoma is a rare mesenchymal soft tissue neoplasm with potential for late local recurrence and metastasis. Here, we review the case and discuss the clinical relevance of narrowing the diagnosis to HPC or the growing umbrella of Solitary Fibrous Tumor (SFT). To our knowledge, this is the first report of intracranial HPC metastatic to the pelvis.

Infantile Hemangiopericytoma: Two Cases Report and Literature Review

Hemangiopericytoma is a rare vascular tumour of infants. Although generally considered to be benign, local recurrence and metastases can occur. Herein, we report on two full term girls, delivered with lumbosacral swelling and left thigh swelling respectively. Complete surgical excision with safety margins was performed for each lesion. Histologic examination of both lesions showed picture of infantile hemangiopericytoma. There is no evidence of local recurrence or distant metastasis during last 20 and 17 months for 1st case and 2nd case respectively. In conclusion;most infantile hemangiopericytoma follow a benign course. Rarely these tumours behave aggressively with local infiltration, recurrences and even distant metastases. Careful follow up is therefore essential.

Lumbar Paraspinal Hemangiopericytoma, An Unusual Location: Surgery with Preoperative Embolization

Background: Lumbar paraspinal hemangiopericytoma is rare. The hemorrhagic nature of the tumor causes problems of hemostasis and makes the resection delicate. We report a rare case of lumbar paraspinal hemangiopericytoma managed with preoperative embolization. Clinical Case: It is about a woman of 31 years, admitted for a large left lumbar paraspinal mass that evolved for 6 years. The clinical exam showed an asymmetry of the left paraspinal muscle. The mass painless was extended from the lumbar region. The neurological exam was normal. MRI showed the left large paraspinal mass tissue. It was extended from lumbar vertebrae, L1 to L4, and measured 100 × 50 × 50 mm. It was an iso-intense signal on T1-weighted with strong enhancement after gadolinium. It was hypervascular and supplied by left intercostal T12, L1, and L2 pedicles. The complete exclusion of the hyper-vascular left paraspinal tumor was obtained after selective embolization of the artery left L1 of the pedicle of the intercostal left L1 and trunks intercostal T12 and L2 left. The total resection of a mass encapsulated was performed. The operative outcome was good. The histology concluded to a hemangiopericytoma. No chemotherapy or radiotherapy was prescribed. After 5 years, the patient was asymptomatic. MRI control confirmed tumor resection with a residue at the level of the left intervertebral foramen L1 - L2. Conclusion: Lumbar paraspinal hemangiopericytoma is an extremely rare tumor. Selective preoperative embolization is recommended before the resection of large tumors to reduce vascular supply. A follow-up extended for these patients is necessary, given the frequency of recurrences.

Recurrent Sinonasal Hemangiopericytoma: A Rare Case Report

Hemangiopericytoma (HPC) is a rare vascular tumor arising from capillary pericytes. This tumor represents 3% - 5% of all soft tissue sarcomas and 1% of all vascular tumors. Only 15% - 30% of cases occur in the head and neck region, among which sinonasal hemangiopericytoma (HPC) is accounted for around 5% of cases. Hemangiopericytoma (HPC) has a tendency for recurrence. Here, a case of recurrent nasal hemangiopericytoma (HPC) after 12 years of treatment is reported.

Chest Wall Hemangiopericytoma-Like Solitary Fibrous Tumor of the Pleura: Case Report with Computed Tomography Findings

We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma.

A Rare Case of a Thoracic Spinal Hemangiopericytoma

Spinal hemangiopericytomas are rare tumors. To date, only 80 cases of spinal hemangiopericytomas have been reported in the literature. The postoperative evolution of this condition in rare cases can be complicated by a symptomatic compressive epidural hematoma that can be the source of serious neurological complications requiring emergency surgery. We report a rare case of intradural and extramedullary spinal hemangiopericytomas with favorable evolution after treatment in an 82 years old woman.

Combined Therapy against Recurrent Hemangiopericytoma:A Case Report

A patient with a seven-year history of recurrent metastatic hemangiopericytoma(HPC) was admitted.During his treatment,he received surgical resection,radiotherapy,radiofrequency hyperthermia and chemotherapy using combined doxorubicin,dacarbazin, vincristine,ginsenoside Rg3,and recombinant human endostatin.This synergistic method provides an encouraging model for treating HPC.

Intracranial hemangiopericytoma with right-sided aortic arch: a case report and summary of experience

Hemangiopericytoma is clinically rare and easily confused with meningioma.Right-sided aortic arch is also a rare disease of congenital cardiovascular variability.The intracranial hemangiopericytoma associated with the right-sided aortic arch has not been reported in the literature.We are here to register a case of right aortic arch concurrent with intracranial hemangiopericytoma;the patient was initially thought to be a simple meningioma,but he was eventually diagnosed as a hemangiopericytoma with right aortic arch and multiple intracranial vascular stenosis and malformation.Whether there was a genetic correlation between the two provides a potential research direction for us.Therefore,the diagnosis and treatment of some rare diseases should be a more comprehensive analysis and evaluation.Adequate examination and accurate diagnosis are crucial,which will directly affect the efficacy of surgery and the prognosis of patients.

Castleman＇s Disease： A Rare Mass in the Pararenal Retroperitoneum that Mimics Other Tumors

Castleman＇s disease （CD） is a rare lymphoproliferative syndrome typically involving a mediastinal mass. CD in the pararenal area should be distinguished from lymphoma diseases. We analyzed the clinical features often CD patients in the pararenal retroperitoneum that mimics other tumors to summarize some of our experiences and conduct a literature review.

Laparoscopic approach of Castleman＇s disease in the pararenal retroperitoneum： report of two cases

Castleman＇s disease （CD） is a benign lymphoid neoplasm characterized by massive proliferation of the lymphoid tissue due to an uncertain cause. Two clinical types （localized, multicentric） have been described with three histological variants （hyaline-vascular, plasma cell and mixed type）. The expected localization is mediastinum and rarely pararenal retroperitoneum. We reported two cases of CD in the pararenal retroperitoneum, one was complicated with autoimmune hemolytic anemia.

Retroperitoneal hemangiopericytoma： case report and literature review

Retroperitoneal hemangiopericytoma is a kind of uncommon tumor. We report a case of 41-year-old man who was diagnosed retroperitoneal tumor without significant symptoms by abdominal ultrasonography. Abdominal CT and MRI scans show a 6 cmx 5 cm solid tumor delineated clearly from adjacent organs. Excision of the tumor was performed and the histopatholoCliCal examination confirmed the diaanosis of hemanoionericvtorna.