EXPERIENCE WITH HEMANGIOPERICYTOMAS IN SK ULL BASE SURGERY

Background: Haemangiopericytomas are rare vascular neoplasms which sho w either slow local tumour growth of aggressive progression in size wi th a high tendency of recurrence and metastasis. Manifestations of hae mangiopericytomas in the area of the nose and sinuses are supposed to have a relatively benign course. To date clinical and histological par ameters for prognosis are uncertain. Therefore in a quite large number of cases only the clinical course allows to evaluate the dignity of a haemangiopericytoma. Patients and Results: We present our experience with five haemangiopericytomas in contact with the skull base out of a total number of 457 skull base tumours. The site of origin of these f ive haemangiopericytomas were: nasal septum, pterygopalatine fossa, or onasopharynx, temporal bone, and parotid gland. All neoplasms showed p rimary or recurrent tumor in contact with the skull base and an intrac ranial extension was observed twice. One patient died postoperatively of a cerebral infarction. Three patients showed one or more recurrence s which were treated surgically. In one case 5 recurrences occured. De spite of 4 surgical procedures within a period of 15 months, the tumou r could be controlled only for a short period of time, and the patient died 16 months after the first operation. Conclusion: One has to cons ider that haemangiopericytomas of the head and neck show a potential m alignant course. The vascular tumor may recur decades later. Adequate therapy and life-long follow -up are therefore mandatory in haemangiop ericytomas. Complete surgical resection of the tumour is usually the t reatment of choice, in spite of the high degree of surgical skill requ ired, especially in advanced tumour and in case of recurrence.