Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root: a case report and literature review. 2011

Samuel Moscovici, and Fernando Ramirez-DeNoriega, and Yakov Fellig, and Guy Rosenthal, and José E Cohen, and Eyal Itshayek
Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

METHODS Review the presentation and diagnosis of an intradural extramedullary hemangiopericytoma of the thoracic spine. OBJECTIVE To present a rare case of intradural, subpial hemangiopericytoma in the thoracic spine, with a brief overview of the literature. BACKGROUND Spinal intradural extramedullary hemangiopericytoma is rare entity that radiographically mimics nerve-sheath tumors. These lesions are typically diagnosed at surgery performed due to suspicion of tumor. METHODS A 20-year-old man who presented with back pain, leg weakness, and sphincter incontinence. MR imaging demonstrated an intradural extramedullary lesion at the T9-T10 level that was isointense on T1- and T2-weighted images and homogeneously enhancing after administration of gadolinium, with cystic components seen on T2-weighted images. The preoperative diagnosis was meningioma or schwannoma. RESULTS At surgery, the lesion was bluish and completely subpial, with apparent nerve root invasion. Pathological examination revealed a neoplasm adjacent to a nerve root with possible focal infiltration. Abundant reticulin fibers and widened, branching vascular channels imparting a staghorn appearance were seen. Up to five mitotic figures were counted in one high-power field. On immunostaining, the neoplastic cells were diffusely immunoreactive for CD99 and immunonegative for EMA, CD34, and S-100 protein. The pathological diagnosis was consistent with anaplastic hemangiopericytoma, WHO grade III. CONCLUSIONS This is the ninth report of spinal intradural hemangiopericytoma. The location of the neoplasm supports the hypothesis that hemangiopericytoma may arise from the spinal pial capillaries.

UI MeSH Term Description Entries
D007150 Immunohistochemistry Histochemical localization of immunoreactive substances using labeled antibodies as reagents. Immunocytochemistry,Immunogold Techniques,Immunogold-Silver Techniques,Immunohistocytochemistry,Immunolabeling Techniques,Immunogold Technics,Immunogold-Silver Technics,Immunolabeling Technics,Immunogold Silver Technics,Immunogold Silver Techniques,Immunogold Technic,Immunogold Technique,Immunogold-Silver Technic,Immunogold-Silver Technique,Immunolabeling Technic,Immunolabeling Technique,Technic, Immunogold,Technic, Immunogold-Silver,Technic, Immunolabeling,Technics, Immunogold,Technics, Immunogold-Silver,Technics, Immunolabeling,Technique, Immunogold,Technique, Immunogold-Silver,Technique, Immunolabeling,Techniques, Immunogold,Techniques, Immunogold-Silver,Techniques, Immunolabeling
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004388 Dura Mater The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord. Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D006393 Hemangiopericytoma A tumor composed of spindle cells with a rich vascular network, which apparently arises from pericytes, cells of smooth muscle origin that lie around small vessels. Benign and malignant hemangiopericytomas exist, and the rarity of these lesions has led to considerable confusion in distinguishing between benign and malignant variants. (From Dorland, 27th ed; DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1364) Hemangiopericytomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071443 12E7 Antigen A cell adhesion molecule that, in humans, is encoded by a gene on the PSEUDOAUTOSOMAL REGION of SEX CHROMOSOMES. It functions in CELL ADHESION of T-LYMPHOCYTES and ROSETTE FORMATION by ERYTHROCYTES. It is also involved in the migration of LEUKOCYTES through the ENDOTHELIUM BASEMENT MEMBRANE. The 12E7 antigen co-localizes with, but functions independently of PECAM-1. 12E7 Protein,Antigens, CD99,CD99 Antigen,CD99 Molecule,E2 Antigen,MIC2 Protein,T-Cell Surface Glycoprotein E2,Antigen, 12E7,Antigen, CD99,Antigen, E2,CD99 Antigens,T Cell Surface Glycoprotein E2
D013125 Spinal Neoplasms New abnormal growth of tissue in the SPINE. Neoplasm, Spinal,Neoplasms, Spinal,Spinal Neoplasm
D013126 Spinal Nerve Roots Paired bundles of NERVE FIBERS entering and leaving the SPINAL CORD at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots are efferent, comprising the axons of spinal motor and PREGANGLIONIC AUTONOMIC FIBERS. Dorsal Roots,Spinal Roots,Ventral Roots,Dorsal Root,Nerve Root, Spinal,Nerve Roots, Spinal,Root, Dorsal,Root, Spinal,Root, Spinal Nerve,Root, Ventral,Roots, Dorsal,Roots, Spinal,Roots, Spinal Nerve,Roots, Ventral,Spinal Nerve Root,Spinal Root,Ventral Root

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