Intracranial Hemangiopericytoma in a 15 Year-old Child: Neuroimaging Features and Management Therapy

Abstract

Introduction: Intracranial hemangiopericytoma (HPR) is a highly vascular tumors which is exceptional in children. They may present management difficulties in some cases. Clinical Presentation: The authors report the case of a 15 year-old female presented with symptoms of increased intracranial pressure. Physical examination featured a frontal syndrome, a Broca’s aphasia, a grade 3 papilledema and a decreased visual acuity in her left eye. Radiological investigation including cranial CT scan and MRI displayed a large dural-based heterogeneous hemorrhagic tumor of the left frontal convexity. The patient underwent a total-gross resection of an extra-parenchymal hemorrhagic tumor through a large frontal craniotomy with no postoperative complications. Pathologic examination of the specimen and immuno-histochemistry concluded to an anaplastic HPR. Postoperative radiotherapy was performed without incidents. A local recurrence was diagnosed four months postoperatively and remained stable after additional radiotherapy. Conclusion: Intracranial anaplastic HPR in children are rare. Imaging features are not specific and may mimics meningioma. Microneurosurgery with adjuvant radiotherapy is required in the management of these aggressive tumors.