1/30/2007 Case 1: (AHCS) Malignant hemangiopericytoma/solitary fibrous tumor

Clinical History:

Atlantic Health Systems Case: A 32 year old man with left leg weakness and a large extra-axial parafalci np tumor .

Diagnostic Notes:

The circulated slide showed a tumor of moderate to high cell density composed of short spindle cells in short fascicles or· more random arrangements. There were foci with dilated blood vessels with thin walls somewhat reminiscent of staghorn vessels wit hout bei ng good examples of such a vascular pattern. There were many mitotic figures and some apoptotic cells . In areas the cells were fairly small and were tightly packed, almost resembling PNET . Discussion cent ered a round the diagnostic entities of Dural (or Meningeal) Hemangiopericytoma, (Malignant) Solitary Fibrous Tumor, Mesenchymal Chondrosarcoma, and related entities . It was suggested by Dr Zagzag that
Monomorphous Synovial Sarcoma would need to be eliminated. Several others emphasized that the tumor was a malighancy of the type formerly reported uniformly as Hemangiopericytoma and that whatever it was called the clinicians should understand the clinical predictions from the pathologic appearance. Dr Bouffard indicated that after many immunostains (CD34+; bcl 2+; EMA+; GFAP; CK; HMB45 all - ; i Reticulin minimal; Ki67 30-40%) and other studies he had signed the case out essentially as a Malignant Solitary FibrousTumor/Hemangiopericytoma (which was also recommended as the diagnosis by Marc Rosenblum) .

Slide Image:

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