A case report of surgical management of hemangiopericytoma at the foramen magnum

Nobuhiko Arai, Satoshi Takahashi, Hatano Mami, Yukina Tokuda, Kazunari Yoshida

Research output: Contribution to journalArticle

Abstract

Background: Hemangiopericytoma (HPC) is a highly vascularized mesenchymal tumor known for its high rates of recurrence and metastasis. The extent of tumor removal is known to be the most trustful prognostic factor. Skull base HPCs are challenging to treat because of the difficulty of the surgical approach and proximity to vital vascular and neuronal structures. We successfully treated a case of HPC at the ventral foramen magnum through surgical gross tumor removal via a far-lateral transcondylar approach. Case Description: A 38-year-old male complained of neck pain and bilateral paresthesia of his shoulders for 2 months, for which he was referred to our hospital. A magnetic resonance image (MRI) showed a 20 mm diameter mass at the ventral foramen magnum, which compressed his medulla oblongata. The tumor was gross totally removed via a far-lateral transcondylar approach. During the surgery, marked bleeding disturbed the surgical field until the main feeding artery from the direction of the dura mater was coagulated and cut. A relatively wide surgical field and a transcondylar approach were helpful to control the bleeding. The pathological examination revealed the tumor to be a HPC. After an uneventful recovery period of 9 days, the patient was discharged without neurological sequelae. Conclusion: We successfully and completely removed an HPC near the foramen magnum, employing a wide surgical field and a transcondylar approach to help control bleeding. When the tumor is suspected preoperatively to be a hemangiocytoma or vascular-rich tumor, a surgical approach that can secure a wide surgical field should be selected.

Original languageEnglish
Article number151
JournalSurgical Neurology International
Volume8
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Foramen Magnum
Hemangiopericytoma
Neoplasms
Hemorrhage
Blood Vessels
Dura Mater
Medulla Oblongata
Neck Pain
Paresthesia
Skull Base
Magnetic Resonance Spectroscopy
Arteries
Neoplasm Metastasis
Recurrence

Keywords

  • Far-lateral approach
  • foramen magnum
  • hemangiopericytoma
  • transcondylar approach

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

A case report of surgical management of hemangiopericytoma at the foramen magnum. / Arai, Nobuhiko; Takahashi, Satoshi; Mami, Hatano; Tokuda, Yukina; Yoshida, Kazunari.

In: Surgical Neurology International, Vol. 8, No. 1, 151, 01.01.2017.

Research output: Contribution to journalArticle

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