Hemangiopericytoma of the head and neck

Objective/Hypothesis: Hemangiopericytomas are uncommon neoplasms of vascula r origin that may arise in the head and neck Their rare occurrence and vari able malignant potential have limited attempts to characterize their clinic al behavior. This study reviews the experience in treating hemangiopericyto mas of the head and neck at a single institution. Study Design: Retrospecti ve. Methods: The records of 12 patients with hemangiopericytomas of the hea d and neck presenting between 1979 and 1995 were reviewed. Site of origin i ncluded the neck (4), oral, cavity (3), parotid (2), orbit (1), maxillary s inus (1) and mandible (1). Five patients had lesions characterized as high or intermediate grade histologically, and six had lesions characterized as low grade. Results: Nine patients were treated with curative intent; three presented either with pulmonary metastasis (2) or unresectable primaries (1 ) and were treated with radiation therapy and/or palliative Adriamycin-base d chemotherapy, Patients treated with curative intent underwent a variety o f surgical resections dictated by tumor location and size. Four patients re ceived postoperative radiation therapy to a median dose of 60 Gy, for posit ive surgical margins (2), high-grade histology (1) or a recurrent lesion (1 ), Five-year overall survival in patients treated surgically was 87,5%, A s ingle mortality occurred in a patient with a recurrent high-grade lesion wh o failed at local, regional, and distant sites. Median follow-up off surviv ors was 73 months. Conclusion: The clinical behavior of hemangiopericytomas appears to be related to their histological grade. Aggressive local therap y including surgery and radiation therapy appears to be effective int provi ding tumor control.