1/14. Primary liver hemangiopericytoma associated with hypoglycemia: report of a second case.hemangiopericytoma is an uncommon vascular tumor which usually develops in soft tissues. It has been exceptionally described in the liver and only one case associated with hypoglycemia has been reported in this organ. A giant hemangiopericytoma which was revealed by life-threatening hypoglycemia is described. Imaging and pathological features are presented. The patient, a 73 year-old woman, was treated by hepatectomy. She is perfectly well after a 3-year follow-up, without any evidence of recurrence.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/14. Giant retroperitoneal hemangiopericytoma with paraneoplastic gynecomastia. Case report and literature review.We report on a 38-year-old patient with a giant retroperitoneal hemangiopericytoma associated with bilateral paraneoplastic gynecomastia, which led to an almost uncontrollable hemorrhage on initial surgery due to the extreme hypervascularity of the process. After angiographic evaluation and superselective embolization, a complete surgical excision of a hemangiopericytoma weighing almost 1,000 g could be achieved. To reduce the risk of recurrence adjuvant radiotherapy with 49 Gy followed. Follow-up of 24 months showed no sign of recurrence on CT scans. To our knowledge this is the first reported case of hemangiopericytoma associated with a paraneoplastic syndrome. The literature and the therapeutic concepts are presented and discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/14. Intrathoracic extrapulmonary tumor mass: hemangiopericytoma.hemangiopericytoma is an uncommon mesenchymal tumor originating from pericytes. We describe the clinical and morphologic features in a case of intrathoracic extrapulmonary giant hemangiopericytoma. The tumor was radically removed, and the microscopy report was benign hemangiopericytoma. Because of the high risk of local recurrence, long-term follow-up is important in such patients.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/14. Haemangiopericytoma of the trigeminal nerve.A 41-year-old man presented with a 4-year history of progressive right-sided diplopia on lateral gaze and right nasolabial paraesthesia. A CT revealed minor bone erosion of Meckel's cave and of the right petrous apex by a uniformly enhancing lesion at the base of the skull. magnetic resonance imaging on three occasions over 2 years showed tumour, measuring 4 cm in diameter, with features suggestive of a trigeminal neuroma. At surgery the lesion had the macroscopic appearance of a giant schwannoma. Histopathological findings were that of a meningeal haemangiopericytoma (HPC) of the trigeminal nerve. Intracranial HPC are rare and aggressive tumours of the central nervous system. They usually arise from the falx, tentorium and dural sinuses. The present case is unique as it originates from a cranial nerve.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/14. Application of recombinant activated factor vii during surgery for a giant skull base hemangiopericytoma to achieve safe hemostasis. Case report.The authors report on a 64-year-old woman with a huge recurrent skull base hemangiopericytoma, in whom they encountered severe difficulty in attaining intraoperative hemostasis. Standard surgical hemostatic methods and the administration of fresh-frozen plasma and prothrombin complex concentrates failed to stop diffuse bleeding from an inoperable tumor remnant. At a critical point during the operation, the intravenous administration of recombinant activated factor vii, combined with mechanical compression, finally led to satisfactory hemostasis. The rationale for using recombinant activated factor vii in situations of uncontrolled bleeding during neurosurgical procedures is discussed, along with the literature in which the use of recombinant activated factor vii as a maneuver of last resort is reported for hemostasis in other surgical fields.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
6/14. Solitary fibrous tumor of the oral mucosa--morphological and immunohistochemical profile in the differential diagnosis with hemangiopericytoma.The objective was to investigate two cases of solitary fibrous tumor (SFT) of oral mucosa, emphasizing the differential diagnosis with one case of oral hemangiopericytoma (HPC), in terms of their morphological and immunohistochemical features. solitary fibrous tumors showed cellularity and collagenization varying from area to area, focal perivascular hyalinization, scattered giant nuclei cells and abundant mast cells throughout the tumor. The hemangiopericytoma case exhibited thin-walled and dilated vessels lined with flat endothelial cells, identified by "staghorn appearance". Tumoral cells of solitary fibrous tumor exhibited immunohistochemical positivity for CD34, as well as endothelial cells. The hemangiopericytoma was positive only in endothelial cells. In solitary fibrous tumor, alpha-smooth muscle actin, h-caldesmon and laminin stained the wall vessels. In hemangiopericytoma, on the other hand, the wall vessels were positive only for laminin, which staining was also observed in perivascular tumoral cells. The morphological and immunohistochemical differences observed allowed us to infer these lesions constitute distinct entities.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/14. Clinical case seminar: Fibroblast growth factor 23: a new clinical marker for oncogenic osteomalacia.The phosphate-wasting condition, oncogenic osteomalacia, is problematic to diagnose and manage clinically due to difficulty in locating the causative tumor. Fibroblast growth factor 23 (FGF23) has recently been implicated in the pathogenesis of oncogenic osteomalacia. In this case the patient presented with clinical features typical of oncogenic osteomalacia. Removal of an angiolipoma from the thigh did not correct the clinical or biochemical abnormalities. Subsequent identification and removal of a benign giant cell tumor in the pubic ramus, however, did result in normalization of his symptoms and signs. Positive staining for FGF23 protein by immunohistochemistry was demonstrated in the giant cell tumor, but not in the angiolipoma. The serum concentration of FGF23 was elevated in preoperative serum, then normalized after removal of the giant cell tumor. Expression of both FGF23 mRNA and protein was demonstrated in the giant cell tumor tissue, and FGF23 mRNA expression and renal phosphate uptake inhibitory activity were also detected in cultured giant cell tumor cells. This case provides further evidence for the involvement of FGF23 in the pathogenesis of oncogenic osteomalacia and for the utility of serum FGF23 measurement and immunohistochemical detection of FGF23 in the diagnosis and clinical management of this condition.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
8/14. Major depression with psychosis after resection of a giant middle fossa hemangiopericytoma.BACKGROUND: Postoperative onset of acute major depression in a patient with no previous history of psychiatric disorder is highly unexpected after skull base surgery. CASE DESCRIPTION: A 38-year-old woman with no previous physical or mental illness presented with a 3-month history of left ear pain, short-term memory disturbance, and motor dysphasia. magnetic resonance imaging revealed a large extraaxial tumor in the left middle fossa. Left temporal craniotomy was performed, achieving complete tumor resection. The patient showed signs of confusion, disorientation, and severe depression 3 days after the surgery. She developed insomnia and auditory hallucinations along with expressed suicidal ideation, then deteriorated rapidly, necessitating a transfer to a psychiatric unit. In spite of the intensive treatment with antidepressive and antipsychotic medications, she continued to have prolonged psychotic symptoms and depression for several months after surgery. CONCLUSION: Although the incidence is rare, psychiatric complications should be anticipated in patients undergoing resection of a large skull base tumor affecting the temporal lobe. The exact mechanism in this process is not clear; however, it is important to clinically differentiate treatable etiologies such as steroid-induced psychosis and postoperative delirium.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
9/14. prenatal diagnosis of a giant congenital primary cerebral hemangiopericytoma.Congenital primary intracranial hemangiopericytomas are exceptionally rare tumors. We present a case of a fetus, with the prenatal sonogram at 33 weeks of gestation revealing a large cerebral tumor. Because of the enlarged head, a cesarean section was performed. The tumor was confirmed by postnatal ultrasound, magnetic resonance imaging (MRI) and biopsy. Elevated intracranial pressure and hemorrhage led to death on the 11th day. autopsy revealed a 10x9 cm large inhomogeneous tumor located centrally, mainly in the posterior fossa. histology showed a hypercellular and hypervascular tumor with extended necrosis and high mitotic rate. The tumor cells were positive for vimentin and CD34 antigens and negative for several neurological markers, desmin and CD31. The diagnosis of a congenital primary cerebral hemangiopericytoma was confirmed.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/14. Giant hemangiopericytoma of mandible: a propos of a case: a variant of the surgical technique for protection of the articular fosse.The hemangiopericytoma is a tumor of the pericytes. It represents 1% of vascular tumors. It is frequently located in inferior limbs, the pelvis, and the retroperitoneum. A painless mass of slow growth is main presentation. Imaging is not specific. Only microscopic and immunohistochemical findings can verify the lesion. The surgical treatment is elective. The search of the world medical literature revealed the publication of only four cases of hemangiopericytoma of the jaw. We present the case of a patient with a giant hemangiopericytoma that originated in the jaw. Studies showed an enormous mass and destruction of the right jaw. A right hemimandibulectomy including the condyle was performed. mandibular reconstruction was performed with titanium plates with condyle and bone graft of the iliac crest; a piece of silastic with titanium mesh was placed in the temporomandibular articular fossa. Two years after surgery, good aesthetic and functional results were evident, and tumor recurrence was not observed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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