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Hemangiopericytoma in the sacrococcygeal space: a case report.

Kitahata Y, Yokoyama S, Takifuji K, Hotta T, Matsuda K, Tominaga T, Oku Y, Watanabe T, Ieda J, Yamaue H - J Med Case Rep (2010)

Bottom Line: A 47-year-old Japanese woman presented with a palpable tumor on the left side of her anus.Preoperative imaging indicated that the tumor was in the sacrococcygeal space without invasion of other organs.A complete resection was performed via a parasacral incision.

View Article: PubMed Central - HTML - PubMed

Affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, Kimiidera, Wakayama, 641-8510, Japan. yokoyama@wakayama-med.ac.jp.

ABSTRACT

Introduction: A hemangiopericytoma is a rare, soft-tissue tumor of vascular origin derived from a pericyte of Zimmerman, which is a modified smooth muscle cell that surrounds the small blood vessels. Hemangiopericytomas can occur wherever there are vascular capillaries. However, there are no previous reports of a hemangiopericytoma in the sacrococcygeal space.

Case presentation: We describe the first reported case of a hemangiopericytoma found in the sacrococcygeal space. A 47-year-old Japanese woman presented with a palpable tumor on the left side of her anus. Preoperative imaging indicated that the tumor was in the sacrococcygeal space without invasion of other organs. A complete resection was performed via a parasacral incision. The histological and immunohistochemical staining patterns supported the diagnosis of a hemangiopericytoma.

Conclusion: A complete resection without piecemeal excision is the best way to treat a hemangiopericytoma. Recognizing the presence of a hemangiopericytoma in the sacrococcygeal space requires appropriate surgery.

No MeSH data available.


Related in: MedlinePlus

(A) Hematoxylin and eosin staining revealing spindle-shaped cells surrounding the endothelial-lined vascular spaces. (B) Immunohistochemistry demonstrating CD34 positive tumor cells. (C) Immunohistochemistry demonstrating Bcl-2 negative tumor cells.
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Figure 3: (A) Hematoxylin and eosin staining revealing spindle-shaped cells surrounding the endothelial-lined vascular spaces. (B) Immunohistochemistry demonstrating CD34 positive tumor cells. (C) Immunohistochemistry demonstrating Bcl-2 negative tumor cells.

Mentions: The pre-operative images indicated that the tumor was not derived from the rectum. Because of its vascularity, the pre-operative diagnosis was a soft-tissue tumor such as a solitary fibrous tumor, fibrous histiocytoma, synovial sarcoma, mesenchymal chondrosarcoma, or hemangiosarcoma. A biopsy was avoided due to the risk of needle track seeding. The patient underwent a tumorectomy via parasacral incision, without a rectectomy, because pre-operative examinations including a CT and EUS revealed that the rectum was intact. The tumor was completely removed (Figure 2A). The excised tumor was 80 × 75 × 65 mm in diameter with a capsule. Its cut surface was mostly grayish-white and partially reddish (Figure 2B). Histopathological features of the hematoxylin and eosin staining revealed that the tumor contained spindle-shaped cells surrounding the endothelial-lined vascular spaces, which is consistent with the histology of hemangiopericytoma (Figure 3A). Argyrophil fibers were seen on silver impregnation surrounding the tumor cells.


Hemangiopericytoma in the sacrococcygeal space: a case report.

Kitahata Y, Yokoyama S, Takifuji K, Hotta T, Matsuda K, Tominaga T, Oku Y, Watanabe T, Ieda J, Yamaue H - J Med Case Rep (2010)

(A) Hematoxylin and eosin staining revealing spindle-shaped cells surrounding the endothelial-lined vascular spaces. (B) Immunohistochemistry demonstrating CD34 positive tumor cells. (C) Immunohistochemistry demonstrating Bcl-2 negative tumor cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823763&req=5

Figure 3: (A) Hematoxylin and eosin staining revealing spindle-shaped cells surrounding the endothelial-lined vascular spaces. (B) Immunohistochemistry demonstrating CD34 positive tumor cells. (C) Immunohistochemistry demonstrating Bcl-2 negative tumor cells.
Mentions: The pre-operative images indicated that the tumor was not derived from the rectum. Because of its vascularity, the pre-operative diagnosis was a soft-tissue tumor such as a solitary fibrous tumor, fibrous histiocytoma, synovial sarcoma, mesenchymal chondrosarcoma, or hemangiosarcoma. A biopsy was avoided due to the risk of needle track seeding. The patient underwent a tumorectomy via parasacral incision, without a rectectomy, because pre-operative examinations including a CT and EUS revealed that the rectum was intact. The tumor was completely removed (Figure 2A). The excised tumor was 80 × 75 × 65 mm in diameter with a capsule. Its cut surface was mostly grayish-white and partially reddish (Figure 2B). Histopathological features of the hematoxylin and eosin staining revealed that the tumor contained spindle-shaped cells surrounding the endothelial-lined vascular spaces, which is consistent with the histology of hemangiopericytoma (Figure 3A). Argyrophil fibers were seen on silver impregnation surrounding the tumor cells.

Bottom Line: A 47-year-old Japanese woman presented with a palpable tumor on the left side of her anus.Preoperative imaging indicated that the tumor was in the sacrococcygeal space without invasion of other organs.A complete resection was performed via a parasacral incision.

View Article: PubMed Central - HTML - PubMed

Affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, Kimiidera, Wakayama, 641-8510, Japan. yokoyama@wakayama-med.ac.jp.

ABSTRACT

Introduction: A hemangiopericytoma is a rare, soft-tissue tumor of vascular origin derived from a pericyte of Zimmerman, which is a modified smooth muscle cell that surrounds the small blood vessels. Hemangiopericytomas can occur wherever there are vascular capillaries. However, there are no previous reports of a hemangiopericytoma in the sacrococcygeal space.

Case presentation: We describe the first reported case of a hemangiopericytoma found in the sacrococcygeal space. A 47-year-old Japanese woman presented with a palpable tumor on the left side of her anus. Preoperative imaging indicated that the tumor was in the sacrococcygeal space without invasion of other organs. A complete resection was performed via a parasacral incision. The histological and immunohistochemical staining patterns supported the diagnosis of a hemangiopericytoma.

Conclusion: A complete resection without piecemeal excision is the best way to treat a hemangiopericytoma. Recognizing the presence of a hemangiopericytoma in the sacrococcygeal space requires appropriate surgery.

No MeSH data available.


Related in: MedlinePlus