Haemangiopericytoma of occipital bone with invasion of the transverse sinus

A 44-year-old man presented with a painless left occipital mass which had e nlarged over 4 months and was neurologically asymptomatic. Computed tomogra phy and magnetic resonance imaging showed a large lytic tumour extending on both sides of the transverse sinus With intracranial and scalp extension. Angiography showed that the tumour was highly vascular. Preoperative emboli sation of some of the main feeding vessels was performed, but a two-staged operation was needed for total removal of the tumour because of profuse ble eding from the tumour and bone. Histological examination :disclosed numerou s thin-walled 'staghorn' shaped capillaries and dense cellularity with atyp ical mitotic figures. The histological diagnosis was a primary haemangioper icytoma of the bone. He received external radiotherapy of 60 Gy. At 2 years follow-up, he remained well without recurrence. The optimal treatment for haemangiopericytoma is radical excision followed by radiation therapy. The need for long-term observation is emphasised because of the notorious tende ncy to recurrence and metastasis. (C) 1999 Harcourt Publishers Ltd.