Intracranial Meningeal Hemangiopericytoma: Case Report and Literature Review

Abstract

Hemangiopericytoma (HPC) is a rare mesenchymal tumor, often located in extracranial areas, and when found in the meninges, it can be mistaken for meningiomas. Intracranial HPC accounts for approximately 0.4% of all brain tumors. These tumors are classified into three types based on biological behavior: benign (Type I), atypical (Type II), and malignant (Type III). Malignant HPCs are characterized by high recurrence rates and metastatic potential. Differential diagnosis between HPC and meningioma is challenging due to similar clinical and radiological features; however, STAT6 immunohistochemical expression is a key marker for differentiation. Imaging techniques such as contrast-enhanced MRI and positron emission tomography (PET) are valuable in preoperative tumor characterization. This report presents a 29-year-old female with recurrent severe headaches and a temporoparietal extra-axial tumor, initially diagnosed as meningioma via imaging. Postoperative histological analysis confirmed the diagnosis of HPC. Despite total surgical resection, the patient experienced local recurrence, requiring further surgical intervention and adjuvant radiotherapy and chemotherapy. HPC is more aggressive than meningioma, with a recurrence rate of 91% and metastasis to various organs. Preoperative embolization can minimize intraoperative bleeding risks due to the tumor's vascularity. Early diagnosis and vigilant postoperative follow-up are critical for improving patient outcomes and managing recurrence and metastasis.