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Introducción: El hemangiopericitoma es un raro tumor mesenquimal (vascularizado y potencialmente maligno) derivado de los pericitos, que puede aparecer en cualquier parte del cuerpo; sin embargo, en el cuello se describen casos aislados. La resección quirúrgica completa constituye la piedra angular del tratamiento. Objetivo: Presentar un caso de un hemangiopericitoma en el cuello, como un caso inusual, con potencial maligno desconocido, diagnóstico y tratamiento oportuno. Presentación de caso: Paciente de sexo masculino, de 39 años de edad, sin antecedentes de enfermedad conocidos, con una masa perceptible a nivel V del cuello derecho. Estudios de imagen muestran un tumor vascularizado de aproximadamente 6 x 7 x 6 cm, entre los músculos escalenos, que fue originado en la arteria cervical profunda. Se confirmó mediante biopsia incisional el hemangiopericitoma, el cual fue tratado mediante resección tumoral completa y radioterapia adyuvante. Actualmente el paciente no tiene actividad tumoral después de su tratamiento inicial. Conclusiones: El hemangiopericitoma en el cuello es raro, el diagnóstico constituye un reto clínico e histológico, ya que, al ser poco común, su potencial maligno resulta desconocido. Aquellos tumores que tienen bajo grado de malignidad pueden ser controlados, de acuerdo a su localización y tamaño, mediante resección completa; mientras que los tumores de alto grado pueden recurrir y dar origen a metástasis. Nuestro paciente tuvo características histopatológicas con invasión capsular, lo que trajo como consecuencia un incremento del riesgo de recurrencia local. Por ese motivo, se decidió aplicar tratamiento adyuvante con radioterapia. El paciente se mantiene sin recurrencia tumoral local y a distancia después de 9 años de vigilancia médica(AU)

Introduction: Hemangiopericytoma is a rare mesenchymal tumor (vascularized and potentially malignant) derived from pericytes. It can occur anywhere in the body; however, isolated cases are described in the neck. Complete surgical resection is the cornerstone of treatment. Objective: To present a case of hemangiopericytoma in the neck, as an unusual case, with unknown malignant potential, as well as its timely diagnosis and treatment. Case presentation: A 39-year-old male patient, with no known history of disease, had a noticeable mass at the V level of the right neck. Imaging studies showed a vascularized tumor of approximately 6 x 7 x 6 cm, between the scalene muscles, which originated in the deep cervical artery. Hemangiopericytoma was confirmed by incisional biopsy, as well as treated by complete tumor resection and with adjuvant radiotherapy. Currently, the patient has no tumor activity after his initial treatment. Conclusions: Hemangiopericytoma in the neck is rare. Its diagnosis is a clinical and histologic challenge because, being uncommon, its malignant potential is unknown. Those tumors with low-grade malignancy can be controlled, according to their location and size, by complete resection; while high-grade tumors may recur and give rise to metastases. Our patient had histopathologic features with capsular invasion, which resulted in an increased risk of local recurrence. For this reason, adjuvant treatment with radiotherapy was decided to be applied. The patient remains without local or distant tumor recurrence after 9 years of medical surveillance(AU)

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BACKGROUND: Hemangiopericytomas (HPCs) are rare tumors derived from mesenchymal cells with pericyte differentiation. About 5% of head and neck HPCs occur in the nasal cavity and paranasal sinuses. Due to its rarity, rich vascularity and variable biological behavior, its management is a challenge in itself. CASE: We report a case of sinonasal HPC in a Jehovah's Witness patient and discuss the obstacles and care related to the restrictions and therapeutic challenges involved in the approach to the patient. The patient was successfully treated by endoscopic endonasal approach with all per-operative care and restrictions being respected and attended. CONCLUSIONS: The management of HPC by itself involves challenges and when associated with other restrictive conditions attention and care are required.

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PURPOSE: Meningiomas are the most common extra-axial intracranial neoplasms with typical radiological findings. In approximately 2% of cases, histopathological reports reveal different neoplasms or non-neoplastic lesions that can closely mimic meningiomas. We describe radiological features of meningioma mimics highlighting imaging red flags to consider a differential diagnosis. METHODS: A total of 348 lesions with radiological diagnosis of meningiomas which underwent to surgical treatment or biopsy between December of 2000 and September of 2014 were analyzed. We determined imaging features that are not a typical finding of meningiomas, suggesting other lesions. The following imaging characteristics were evaluated on CT and MRI: (a) bone erosion; (b) hyperintensity on T2WI; (c) hypointensity on T2WI; (d) bone destruction; (e) dural tail; (f) leptomeningeal involvement; (g) pattern of contrast enhancement; (h) dural displacement sign. RESULTS: We have a relatively high prevalence of meningioma mimics (7.2%). Dural-based lesions with homogeneous contrast enhancement (52%) are easily misdiagnosed as meningiomas. Most lesions mimic convexity (37.5%) or parafalcine (21.9%) meningiomas. We have determined five imaging red flags that can alert radiologists to consider meningioma mimics: (1) bone erosion (22.2%); (2) dural displacement sign (36%); (3) marked T2 hypointensity (32%); (4) marked T2 hyperintensity (12%); (5) absence of dural tail (48%). The most common mimic lesion in our series was hemangiopericytomas, followed by lymphomas and schwannomas. CONCLUSION: The prevalence of meningioma mimics is not negligible. It is important to have awareness on main radiological findings suggestive of differential diagnosis due to a wide range of differentials which lead to different prognosis and treatment strategies.

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Resumen El tumor fibroso solitario/ hemangiopericitoma (TFS/HP) es un tumor extraaxial de origen mesenquimático de infrecuente observación, que usualmente se confunde con el meningioma, del cual puede ser clínica y radiológicamente indistinguible. El análisis molecular con la detección de la expresión nuclear STAT6 (signal transducer and activator of transcription 6) o la fusión NAB2-STAT6 (NGFI-A binding protein 2) es recomendable para confirmar el diagnóstico. Presentamos 3 casos clínicos, 2 mujeres y 1 varón, con diagnóstico anatomopatológico de meningioma meningotelial en el primer caso; y los casos 2 y 3 con sospecha radiológica de meningioma. La revisión anatomopatológica con estudio molecular permitió certificar el diagnóstico de TFS/ HP. Para el diagnóstico diferencial entre TFS/HP meníngeo y meningioma, se recomienda buscar la expresión de STAT6 como primer paso o la fusión NAB2-STAT6. La revisión de las muestras de biopsia debe estar garantizada en todos los pacientes, inclusive en aquellas que fueron estudiadas en Servicios de Patología Nivel 3.

Abstract The solitary fibrous tumor/ hemangiopericytoma (TFS/HP) is a rare mesenchymal extraaxial tumour. TFS/HP can sometimes be difficult to distinguish from other extra-axial tumors like meningioma, which can be clinically and radiologically indistinguishable. Molecular analysis with STAT6 (signal transducer and activator of transcription 6) nuclear expression or NAB2-STAT6 (NGFI-A binding protein 2) fusion is recommended to confirm the diagnosis. We present 3 cases, 2 women and 1 male, with pathological diagnosis of meningothelial meningioma in the first case; cases 2 and 3 with radiological suspicion of meningioma. The pathological review with molecular study certified the diagnosis of TFS/HP. For differential diagnosis between meningeal TFS/HP and meningioma, it is recommended to look for STAT6 expression as a first step, or NAB2-STAT6 fusion in order to confirm TFS/HP. The review of biopsy samples must be guaranteed in all patients, including those who were studied in Pathology Services Level 3.

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The solitary fibrous tumor/ hemangiopericytoma (TFS/HP) is a rare mesenchymal extraaxial tumour. TFS/HP can sometimes be difficult to distinguish from other extra-axial tumors like meningioma, which can be clinically and radiologically indistinguishable. Molecular analysis with STAT6 (signal transducer and activator of transcription 6) nuclear expression or NAB2-STAT6 (NGFI-A binding protein 2) fusion is recommended to confirm the diagnosis. We present 3 cases, 2 women and 1 male, with pathological diagnosis of meningothelial meningioma in the first case; cases 2 and 3 with radiological suspicion of meningioma. The pathological review with molecular study certified the diagnosis of TFS/HP. For differential diagnosis between meningeal TFS/HP and meningioma, it is recommended to look for STAT6 expression as a first step, or NAB2-STAT6 fusion in order to confirm TFS/HP. The review of biopsy samples must be guaranteed in all patients, including those who were studied in Pathology Services Level 3.

El tumor fibroso solitario/ hemangiopericitoma (TFS/HP) es un tumor extraaxial de origen mesenquimático de infrecuente observación, que usualmente se confunde con el meningioma, del cual puede ser clínica y radiológicamente indistinguible. El análisis molecular con la detección de la expresión nuclear STAT6 (signal transducer and activator of transcription 6) o la fusión NAB2-STAT6 (NGFI-A binding protein 2) es recomendable para confirmar el diagnóstico. Presentamos 3 casos clínicos, 2 mujeres y 1 varón, con diagnóstico anatomopatológico de meningioma meningotelial en el primer caso; y los casos 2 y 3 con sospecha radiológica de meningioma. La revisión anatomopatológica con estudio molecular permitió certificar el diagnóstico de TFS/HP. Para el diagnóstico diferencial entre TFS/HP meníngeo y meningioma, se recomienda buscar la expresión de STAT6 como primer paso o la fusión NAB2-STAT6. La revisión de las muestras de biopsia debe estar garantizada en todos los pacientes, inclusive en aquellas que fueron estudiadas en Servicios de Patología Nivel 3.

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BACKGROUND: Solitary fibrous tumour is an unusual neoplasm of the oral cavity that is sometimes not clinically distinguishable from other lesions. The purpose of the present study was to review the clinical, microscopic and molecular aspects of malignant and benign solitary fibrous tumour of the oral cavity currently available in literature. METHODS: For our review, an electronic search was performed using PubMed, Scopus, Ovid/MedLine, Web of science and ProQuest Dissertations and Theses Global database. RESULTS: A total of 74 publications reporting 150 cases were included. Oral solitary fibrous tumours are most frequently described as submucosal, well-circumscribed, asymptomatic nodule, more prevalent in females in their fourth to fifth decades of life. Buccal mucosa is the most commonly affected site by the benign tumour variant, whereas the tongue is the most common location affected by the malignant form of the neoplasm. Most of the lesions were treated by conservative surgery. One recurrent malignant tumour and one metastasis are reported. CONCLUSION: Asymptomatic normal-coloured submucosal nodules located in the buccal mucosa and tongue in adult patients are suggestive of oral solitary fibrous tumour, but only a careful microscopic examination can differentiate benign from malignant variants and the use of immunohistochemistry (CD34, Bcl-2, CD99 and STAT6), and cytogenetic studies (NAB2-STAT6) contribute significantly to confirm the diagnosis of solitary fibrous tumour in difficult cases.

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OBJECTIVE: To report the use of two techniques (radiosurgery and en bloc vertebrectomy) on the same patient for the treatment of two metastases in different sites of the spine arising from intracranial hemangiopericytoma. Intracranial hemangiopericytomas are rare, comprising approximately 2.4% of meningeal tumors and <1% of all tumors of the central nervous system. Metastases to the spine are even rarer: The largest case series reported in the literature has 5 and 7 cases. METHODS: A 37-year-old man diagnosed with intracranial hemangiopericytoma was referred for a metastatic lesion in T12 and underwent en bloc resection using the Tomita technique. RESULTS: The disease evolved with a metastasis to T2 treated by radiosurgery with 1600 cGy. The patient died 1,706 days after the en bloc resection of T12 and 1324 days after the radiosurgery of T2, and no recurrence occurred in these locations due to progression of the systemic diseases (liver and central nervous system). CONCLUSION: This is the first case reported in the literature in which two different techniques were used to treat metastatic lesions in the spine from an intracranial hemangiopericytoma and is unique for its use of two treatments in the same patient. Level of evidence: V, case report.

OBJETIVO: Reportar o uso de duas técnicas (radiocirurgia e vertebrectomia em bloco) no mesmo paciente, para o tratamento de metástases de um hemangiopericitoma intracraniano em dois locais da coluna. Hemangiopericitomas intracranianos são raros, consistindo em cerca de 2,4% dos tumores da meninge e menos de 1% de todos os tumores do sistema nervoso central, e metástases para a coluna são ainda mais raras: as maiores séries de casos publicada tinham 5 e 7 casos. MÉTODOS: Um homem de 37 anos com diagnóstico de hemangiopericitoma intracraniano foi encaminhado para resecção em bloco de lesão metastática em T12 com a técnica de Tomita. RESULTADOS: A doença evoluiu com metástase em T2, tratada com radiocirurgia (dose de 1600 cGy). O paciente morreu 1.706 dias após a resecção em bloco de T12 e 1.324 dias após a radiocirurgia de T2, livre de recorrência nessas localizações, devido a progressão sistêmica da doença (para fígado e sistema nervoso central). CONCLUSÃO: Este é o primeiro caso na literatura no qual duas técnicas diferentes foram usadas pra tratar lesões metastáticas da coluna de hemangiopericitoma intracraniano, único pelo uso de duas técnicas de tratamento no mesmo paciente. Nível de evidência V, relato de caso.

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ABSTRACT Objective: To report the use of two techniques (radiosurgery and en bloc vertebrectomy) on the same patient for the treatment of two metastases in different sites of the spine arising from intracranial hemangiopericytoma. Intracranial hemangiopericytomas are rare, comprising approximately 2.4% of meningeal tumors and <1% of all tumors of the central nervous system. Metastases to the spine are even rarer: The largest case series reported in the literature has 5 and 7 cases. Methods: A 37-year-old man diagnosed with intracranial hemangiopericytoma was referred for a metastatic lesion in T12 and underwent en bloc resection using the Tomita technique. Results: The disease evolved with a metastasis to T2 treated by radiosurgery with 1600 cGy. The patient died 1,706 days after the en bloc resection of T12 and 1324 days after the radiosurgery of T2, and no recurrence occurred in these locations due to progression of the systemic diseases (liver and central nervous system). Conclusion: This is the first case reported in the literature in which two different techniques were used to treat metastatic lesions in the spine from an intracranial hemangiopericytoma and is unique for its use of two treatments in the same patient. Level of evidence: V, case report

RESUMO Objetivo: Reportar o uso de duas técnicas (radiocirurgia e vertebrectomia em bloco) no mesmo paciente, para o tratamento de metástases de um hemangiopericitoma intracraniano em dois locais da coluna. Hemangiopericitomas intracranianos são raros, consistindo em cerca de 2,4% dos tumores da meninge e menos de 1% de todos os tumores do sistema nervoso central, e metástases para a coluna são ainda mais raras: as maiores séries de casos publicada tinham 5 e 7 casos. Métodos: Um homem de 37 anos com diagnóstico de hemangiopericitoma intracraniano foi encaminhado para resecção em bloco de lesão metastática em T12 com a técnica de Tomita. Resultados: A doença evoluiu com metástase em T2, tratada com radiocirurgia (dose de 1600 cGy). O paciente morreu 1.706 dias após a resecção em bloco de T12 e 1.324 dias após a radiocirurgia de T2, livre de recorrência nessas localizações, devido a progressão sistêmica da doença (para fígado e sistema nervoso central). Conclusão: Este é o primeiro caso na literatura no qual duas técnicas diferentes foram usadas pra tratar lesões metastáticas da coluna de hemangiopericitoma intracraniano, único pelo uso de duas técnicas de tratamento no mesmo paciente. Nível de evidência V, relato de caso.

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Solitary fibrous tumor (SFT) is a spindle-shaped cell neoplasm originally described in the pleura, but subsequently found in many anatomic sites. Only few cases of primary SFTs in the bone have been previously described in the literature. We present the case of an 86-year-old man with a 1-week history of pain in his left arm. Imaging studies demonstrated a well-defined osteolytic lesion in the proximal humerus measuring 6.1 cm in diameter. Sections showed a round to spindle-shaped cell neoplasm with prominent mitotic activity (28 mitoses per 10 high-power fields) and areas of necrosis, focally surrounding staghorn-shaped vessels. The tumor cells were positive for CD34, CD99, Bcl-2, and STAT6 and negative for smooth muscle actin, epithelial membrane antigen, and cytokeratin AE1/AE3. These findings were consistent with a malignant SFT involving the left humerus. Although extremely rare, SFT should be considered in the differential diagnosis of primary bone tumors. This is the first case report of a primary SFT in a long bone with malignant histological features.

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ABSTRACT Introduction: Hemangiopericytoma is a rare vascular tumor of the sinonasal region, associated with epistaxis and nasal obstruction as the main symptoms. When located in this region, it has special clinical characteristics that differentiate it from others. Case presentation: The following paper reports the case of a 43-year-old female patient presenting with right nasal obstruction and 6 months of evolution associated with mucopurulent rhinorrhea and recurrent right side epistaxis. Physical examination showed a right obstructive mass originating from the cribriform plate. Computed tomography of the paranasal sinuses revealed a complete blockage of the right nasal cavity by a homogeneous content, with soft tissue density and no evident contrast enhancement. The lesion extended superiorly to the cribriform plate but without intracranial or orbital extension. The patient was treated with endoscopic surgery and anatomopathological study revealed sinonasal hemangiopericytoma. The patient had complete remission and subsequent 3-year follow-up without recurrence. Conclusion: The recommended treatment for hemangiopericytoma is total surgical excision with free margins. The results are generally good and the risk of recurrence seems to be associated with incomplete tumor excision. A literature review is presented and its main characteristics are discussed.

RESUMEN Introducción: El hemangiopericitoma es un tumor vascular poco frecuente en la región nasosinusal que se asocia con epistaxis y obstrucción nasal como principales síntomas. Cuando se presenta en esta región, tiene características clínicas especiales que lo hace diferente de otras localizaciones. Presentación del caso: A continuación se presenta el caso de una paciente de 43 años de edad, con síntomas de obstrucción en fosa nasal derecha y 6 meses de evolución asociados con rinorrea mucopurulenta y epistaxis recurrente del lado derecho. El examen físico mostró una masa obstructiva en el lado derecho con origen en la placa cribriforme. Una tomografía computarizada de los senos paranasales reveló un bloqueo completo de la cavidad nasal derecha por un contenido homogéneo, con densidad de partes blandas, sin captación de contraste evidente. La lesión se extendía hacia el lado superior de la placa cribriforme, sin extensión intracraneal u orbitaria. La paciente fue tratada con cirugía endoscópica y el estudio anatomopatológico reveló un hemangiopericitoma sinonasal. La paciente tuvo remisión completa y se realizó seguimiento por 3 años sin recurrencia. Conclusión: El tratamiento recomendado para el hemangiopericitoma es la escisión quirúrgica total con márgenes libres, cuyos resultados son generalmente buenos. El riesgo de recurrencia parece estar asociado con una escisión tumoral incompleta. Se presenta una revisión de literatura, así como comentarios sobre sus características principales.

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ABSTRACT Glomangiopericytomas are soft tissue tumors showing distinct perivascular myoid differentiation in sinonasal region that correspond to less than 0.5% of neoplasms in this region. We report the case of a 39-year-old patient with intranasal tumor of hemangiopericytoid pattern and immunohistochemistry compatible with glomangiopericytoma. We opted for external and endonasal surgical treatment, with preoperative embolization. Glomangiopericytomas are uncommon and are characterized by frequent recurrence, but metastases are rare. Generally painless, they present with unilateral nasal obstruction and/or epistaxis, with a polypoid, reddish and friable mass, and the diagnosis can be confirmed by histopathological and immunohistochemical examination.

RESUMO Glomangiopericitomas são tumores de partes moles que apresentam diferenciação mioide perivascular distinta na região sinunasal e correspondem a menos de 0,5% das neoplasias dessa região. Relatamos o caso de um paciente de 39 anos de idade com tumoração intranasal de proliferação celular de padrão hemangiopericitoide e imuno-histoquímico compatível com glomangiopericitoma. Optou-se por tratamento cirúrgico externo e endonasal, com embolização pré-operatória. Os glomangiopericitomas são incomuns e caracterizam-se pela recorrência frequente, sendo raras as metástases. Geralmente indolores, apresentam-se com obstrução nasal unilateral e/ou epistaxe, com massa de aspecto polipoide, avermelhada e friável. O diagnóstico pode ser confirmado pelo exame histopatológico e imuno-histoquímico.

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El glomangiopericitoma es un tumor nasosinusal extremadamente raro, más frecuente en pacientes de edad avanzada y en mujeres. Si bien su etiopatogenia es desconocida, se reconocen ciertos factores predisponentes tales como hipertensión arterial, embarazo, trauma y uso de corticoides. Para su diagnóstico, resulta necesario recurrir tanto a estudio por imágenes como a la histología y técnicas de inmunohistoquímica. Microscópicamente se caracteriza por un prominente crecimiento perivascular de células uniformes ovales o fusiformes, dispuestas en fascículos cortos intercalados con capilares de diámetros variables ramificados en "asta de ciervo" y presenta inmuno-rreactividad positiva para actina, factor XIII-A y vimentina principalmente. Clínicamente este tumor presenta un comportamiento generalmente benigno, pero con una elevada tasa de recurrencia. Presentamos el caso de una mujer de 71 años, con antecedentes de hipertensión arterial, que acudió a nuestro centro por rinorrea purulenta y epistaxis unilateral derecha de 5 años de evolución. Al examen se observa masa polipoidea en fosa nasal derecha con abundante vascularización, sin otros hallazgos al examen físico. La lesión es resecada en su totalidad mediante cirugía endoscópica. El estudio histológico e inmunohistoquímico son compatibles con glomangiopericitoma. La paciente evoluciona con remisión de su sintomatología y a los dos meses desde la resección no ha presentado evidencias de recurrencia.

Glomangiopericytoma is an extremely rare sinonasal tumor, more common among elderly and women. Although its etiology and pathogeny are unknown, there are certain predisposing factors, such as arterial hypertension, pregnancy, trauma and corticosteroids. To diagnose this tumor, it is necessary imaging, histopathologic and inmunohistochemical studies. At the microscopic study, it is characterized by a prominent perivascular growth of oval-shaped or fusiform cells, arranged in short fascicles separated by capillary vessels of variable diameters, with staghorn-like ramifications, and lmmunohistochemistry positive mainly for actin, XIII-A factor and vimentin. Clinically, this tumor has a generally benign behavior, but with high recurrence percentage. We present the case of a 71 years old woman, with history of hypertension, who present in our center with a 5 years history of purulent rhinorrhea and right unilateral epistaxis, at the physical exam there is a polypoid mass in the right nasal fossa with rich vascularization, with no other findings. This tumor was resected entirely with endoscopic surgery. Histology and immunohistochemistry were compatible witch gomangiopericytoma. The patient evolve with remission of her symptoms and with no signs of recurrence at two-month follow-up.

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Se presenta caso de paciente masculino de 28 años, sin antecedentes médicos de importancia, con síndrome convulsivo primer evento. Se le realiza estudio de imagen donde se documenta lesión ocupativa extraaxial temporo ­ occipito ­ cerebelar derecha. Paciente es llevado a resección de tumor. Se obtiene hallazgo histopatológico de tumor fibroso solitario meningeo. Además se documenta foco irritativo cortical a este mismo nivel. El tumor fibroso solitario meningeo representa un espectro de tumores mesenquimales, agrupado actualmente por la Clasificación de la OMS como Tumor fibroso solitario/ Hemangiopericitoma grado 1. El tratamiento se basa en resección quirúrgica amplia y vigilancia a largo plazo...(AU)

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Introducción: En 1942 Stout y Murray describieron un tumor extraneural compuesto por una proliferación de vasos sanguíneos con endotelio normal rodeados de células neoplásicas que presumiblemente surgían de los Pericitos. La Neoplasia fue llamada Hemangiopericitoma. Se trata de un tumor agresivo, más frecuente en adultos. En los niños son extremadamente raros, solo 11 casos han sido reportados en la literatura. Se originan de la transformación maligna de los Pericitos de Zimmerman. Descripción del caso: Presentamos el caso de una adolescente de 16 años, con antecedente de convulsiones generalizadas en el año 2009, detectándose en el 2014 lesión ocupante de espacio parieto-occipital derecha, la cual es extirpada, informándose como meningioma. Evoluciona con recidiva tumoral 3 meses más tarde, evaluándose por inmunomarcación nueva muestra de lesión, con la que se arriba al diagnóstico de hemangiopericitoma. Conclusión: El Hemangiopericitoma cerebral es una patología rara, de muy baja prevalencia, y de gran similitud clínica e imagenológica con los meningiomas. Incluso genera gran cantidad de diagnósticos erróneos con la histopatología convencional. Por todo lo antes mencionado, es muy importante tener presente esta patología a la hora de pensar en diagnósticos diferenciales de meningiomas, siendo fundamental la inmunomarcación para confirmar uno u otro diagnóstico.

Introduction: In 1942, Stout and Murray described an extraneural tumor composed of a proliferation of blood capillaries with normal endothelium and surrounded by neoplastic cells, which presumably arose from pericytes. The neoplasm was thus labeled an hemangiopericytoma. This aggressive tumor is more common in adults than in children, in whom it is extremely rare, with only 11 cases reported in the literature. It stems from the malignant transformation of pericytes of Zimmerman. Case report: We present the case of a 16-year old teen with a history of generalized seizures in 2009, in whom a spaceoccupying parieto-occipital lesion was detected and removed in 2014, at which time it was diagnosed as a meningioma. However, upon tumor recurrence three months later, further immuno-staining revealed the lesion to be a hemangiopericytoma. Conclusion: Cerebral hemangiopericytomas have a very low prevalence and high degree of clinical and imaging similarity with meningiomas. This similarity frequently leads to misdiagnosis with conventional histopathology. For this reason, it is crucial to remember this pathology in the differential diagnosis of a meningioma, so that appropriate immuno-staining is performed to either confirm or rule out its presence.

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A casuística de cães diagnosticados com neoplasias vem aumentando consideravelmente. O hemangiopericitoma canino é uma neoplasia mesenquimal que geralmente apresenta-se como nódulo único, multilobular, de consistência firme, localizado preferencialmente em região de articulação úmero-radio-ulnar e fêmuro-tibio-patelar. Os retalhos axiais geniculares são utilizados para recobrir defeitos na tíbia lateral e medial e na articulação tibiotársica. O objetivo deste trabalho é descrever um caso atendido no Hospital Veterinário da Universidade de Marília - UNIMAR de um cão com diagnóstico de hemangiopericitoma em que foi realizada cirurgia reconstrutiva com a técnica de flap axial genicular. O domínio de técnicas de cirurgia reconstrutiva permite a realização do procedimento adequado, proporcionando recuperação rápida, de baixo custo, com excelente resultado estético e funcional.

The casuistry of dogs diagnosed with neoplastic has increased considerably. Canine hemangiopericytoma is a mesenchyme neoplasm that usually presents itself as a single nodule, multilobular, firm consistency, preferentially located in the region of the umero-radio-ulna joint and femur-tibia-patellar. The genicular axial flaps are used to cover defects in the lateral and medial tibia and tibiotarsal joints. The objective of this study is to describe a case in the Veterinary Hospital of the University of Marilia - UNIMAR of a dog diagnosed withhemangiopericytoma, it was performed reconstructive surgery with genicular axial flap technique. The domain of reconstructive surgery techniques allows performing the appropriate procedure, providing fast recovery, low cost, with excellent aesthetic and functional result.

La serie de los perros diagnosticados con cáncer ha aumentado considerablemente. Hemangiopericitoma canina es una neoplasia mesenquimal que por lo general se presenta como un nódulo único, multilobular, consistencia firme, preferiblemente ubicado en la región del húmero-radio-cubital y la articulación femoro-tibio-rotuliana. Las aletas axiales geniculares se utilizan para cubrir defectos de la tibia y el corvejón conjunta lateral y medial. El objetivo de este estudio es describir un caso el Hospital Veterinario de la Universidad de Marilia - UNIMAR un perro diagnosticado con hemangiopericitoma que se realizó la cirugía reconstructiva con técnica de colgajo axial genicular. Las técnicas de cirugía reconstructiva de dominio permite llevar a cabo el procedimiento adecuado, proporcionando una rápida recuperación, de bajo costo, con un excelente resultado estético y funcional.

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A casuística de cães diagnosticados com neoplasias vem aumentando consideravelmente. O hemangiopericitoma canino é uma neoplasia mesenquimal que geralmente apresenta-se como nódulo único, multilobular, de consistência firme, localizado preferencialmente em região de articulação úmero-radio-ulnar e fêmuro-tibio-patelar. Os retalhos axiais geniculares são utilizados para recobrir defeitos na tíbia lateral e medial e na articulação tibiotársica. O objetivo deste trabalho é descrever um caso atendido no Hospital Veterinário da Universidade de Marília - UNIMAR de um cão com diagnóstico de hemangiopericitoma em que foi realizada cirurgia reconstrutiva com a técnica de flap axial genicular. O domínio de técnicas de cirurgia reconstrutiva permite a realização do procedimento adequado, proporcionando recuperação rápida, de baixo custo, com excelente resultado estético e funcional.(AU)

The casuistry of dogs diagnosed with neoplastic has increased considerably. Canine hemangiopericytoma is a mesenchyme neoplasm that usually presents itself as a single nodule, multilobular, firm consistency, preferentially located in the region of the umero-radio-ulna joint and femur-tibia-patellar. The genicular axial flaps are used to cover defects in the lateral and medial tibia and tibiotarsal joints. The objective of this study is to describe a case in the Veterinary Hospital of the University of Marilia - UNIMAR of a dog diagnosed withhemangiopericytoma, it was performed reconstructive surgery with genicular axial flap technique. The domain of reconstructive surgery techniques allows performing the appropriate procedure, providing fast recovery, low cost, with excellent aesthetic and functional result. (AU)

La serie de los perros diagnosticados con cáncer ha aumentado considerablemente. Hemangiopericitoma canina es una neoplasia mesenquimal que por lo general se presenta como un nódulo único, multilobular, consistencia firme, preferiblemente ubicado en la región del húmero-radio-cubital y la articulación femoro-tibio-rotuliana. Las aletas axiales geniculares se utilizan para cubrir defectos de la tibia y el corvejón conjunta lateral y medial. El objetivo de este estudio es describir un caso el Hospital Veterinario de la Universidad de Marilia - UNIMAR un perro diagnosticado con hemangiopericitoma que se realizó la cirugía reconstructiva con técnica de colgajo axial genicular. Las técnicas de cirugía reconstructiva de dominio permite llevar a cabo el procedimiento adecuado, proporcionando una rápida recuperación, de bajo costo, con un excelente resultado estético y funcional.(AU)

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El tumor fibroso solitario del hígado es infrecuente. Hasta la fecha, se han reportado menos de 50 casos en la literatura científica inglesa, la mayoría de los cuales se comportaron como tumores benignos. El objetivo del presente artículo es actualizar el conocimiento sobre este tumor porque, debido a su rareza, la presentación clínica, el estudio, el tratamiento y el pronóstico no son bien conocidos. Habitualmente, no produce sintomatología o es inespecífica y su comportamiento a largo plazo es incierto; no obstante, en algunos casos, se comporta agresivamente como un sarcoma de mal pronóstico. Actualmente, solo el tratamiento quirúrgico puede ofrecer una oportunidad terapéutica para estos pacientes. Debido a la falta de conocimiento sobre el comportamiento a largo plazo de estos tumores supuestamente benignos y a la falta de tratamiento médico específico, se sugiere el seguimiento metódico a largo plazo para garantizar la supervivencia de los pacientes operados por un tumor fibroso solitario del hígado.

Solitary fibrous tumors of the liver (SFTL) are uncommon tumors. To the present day less than 50 cases has been reported in the scientific English literature, most of which behaved as benign tumors. The present article has the main purpose of updating knowledge on SFTL because, due to its rarity, its clinical presentation, study, treatment and prognosis, are not well known. The clinical presentation, radiologic study, surgical treatment, immunohistochemical study and prognosis are updated and comprehensively discussed. The SFTL is an uncommon neoplasm. The clinical presentation is habitually indolent and its behavior is uncertain. In some cases, the SFTL acts as an aggressive sarcoma with poor prognosis. Currently, only surgery offers a therapeutic opportunity for these patients. Due to the lack of current knowledge on the long-term behavior of supposedly benign SFTLs and to the lack of specific therapies, methodical long-term follow-up is essential to ensure the survival of patients treated for SFTL.

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Hemangioperycytoma is a rare perivascular tumor that seldom involves the urogenital system. This tumor often appears with an unspecific clinical picture, and sometimes is associated with hematuria or hypertension. Diagnosis is based on a combination of histological and immunohistological findings. We report a case of a 52-year-old patient with renal hemangiopericytoma who underwent surgical treatment at our service. This report also includes a literature review on the subject.

Hemangiopericitoma é um raro tumor perivascular que raramente envolve o sistema urogenital. Esses tumores geralmente se manifestam com quadro clínico inespecífico, por vezes associado a hematúria ou hipertensão. O diagnóstico baseia-se numa combinação de alterações histológicas e imuno-histológica. Este artigo relatou o caso de uma paciente de 52 anos de idade com um hemangiopericitoma renal submetida a tratamento cirúrgico em nosso serviço e incluiu uma revisão de literatura sobre o assunto.

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Introducción: El hemangiopericitoma es un tumor vascular inusual originado de los pericitos que rodean los capilares, sólo el 10 al 15% de todos los hemangiopericitomas ocurren en cabeza y cuello. Su presentación clínica más frecuente es la de una masa nasal que sangra fácilmente con la manipulación. A pesar del manejo quirúrgico con resecciones completas, se ha observado una tasa de recurrencia no despreciable, y de transformación maligna que pueden ocurrir incluso décadas después del tratamiento. Objetivo: Se presenta un caso de una paciente en quien se diagnosticó un hemangiopericitoma nasosinusal. Diseño: Reporte de caso. Materiales y métodos: Se presenta el caso de una paciente de 57 años con cuadro de 3 años de obstrucción nasal izquierda y episodios de epistaxis recurrente, clínicamente se evidencia una masa rojiza de aspecto polipoide, que ocupa la totalidad del meato nasal común. La inspección endoscópica muestra su origen en la región etmoidal. Previa embolización, se practica resección endoscópica de la totalidad de la lesión con bordes de resección libres. Resultados: El reporte histopatológico confirma un hemangiopericitoma. Conclusiones: El hemangiopericitoma es un tumor infrecuente de la cavidad nasal y los senos paranasales, que amerita una alta sospecha clínica para diagnosticarse pre-quirúrgicamente, siendo crucial el estudio endoscópico e imagenológico para determinar su origen vascular; confirmándose con el estudio inmunohistoquímico. El abordaje endoscópico permite la resección de la totalidad de la lesión; la embolización preoperatoria disminuye el volumen del tumor y facilita el control del sangrado intraquirúrgico

Introduction: Hemangiopericytoma is a rare vascular tumor originated from pericytes surrounding capillaries; only 10 to 15% of total hemangiopericytomas occur in the head and neck. The most common clinical presentation is that of a nasal mass that bleeds easily when is handled. Despite surgery treatment with complete resection, there has been an appreciable recurrence rate, and malignant transformation may occur even decades after treatment. Objective: A case of a woman who was diagnosed with sinonasal hemangioperycitoma is presented. Design: Case report. Materials and methods: We report a case of a 57 years old female with left nasal obstruction and recurrent episodes of epistaxis during the past three years, physical examination revealed a reddish polypoid mass, involving the common nasal meatus. Nasal endoscopic inspection shows its origin in the ethmoid region. After embolization, endoscopic resection of the entire lesion was performed. Results: The histopathological report confirms hemangiopericytoma. Conclusions: Hemangiopericytoma is a rare tumor of the nasal cavity and sinuses, which deserves a high clinical suspicion to be diagnosed previous to surgery, being endoscopic and imaging test crucial to determine its vascular origin; it is confirmed by immunohistochemical study. The endoscopic approach allows resection of the entire lesion; preoperative embolization decreases tumor volume and facilitates control of intraoperative bleeding.

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