Order the intracranial detectable disease
1. What are the signifi cant fi ndings in the MRI?
2. What is your diff erential diagnosis?
3. What would be your initial management?
The patient was operated through a right frontotemporal craniotomy. The surgery had to be staged because of
extensive bleeding. Gross total resection was achieved
after the second stage ( Fig. 8.2 ). The tumor histology confi rmed the diagnosis of hemangiopericytoma.
4. How is hemangiopericytoma classifi ed in the most
recent World Health Organization (WHO) classifi cation
in 2007, and how does it diff er from meningioma in
this classifi cation?
5. Is there any role for adjuvant treatment?
Following surgery, the patient received intensity modulated radiotherapy (IMRT).
Seven years after his initial surgery and radiotherapy,
he had a recurrence to the left ventral petrous region,
which was treated with surgery and IMRT. Nine years
after his initial surgery, he developed recurrence to his
original tumor bed, which was resected.
At the time of his second recurrence, a metastasis was
detected in his pancreas, which was treated with radiotherapy. Currently, he is 11 years out of his fi rst surgery,
with no intracranial detectable disease and stable pancreatic metastasis.
6. What is the prognosis for hemangiopericytoma?
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