Haemangiopericytoma diagnosed from a metastasis 11 years after surgery for"atypical meningioma"

Meningeal haemangiopericytoma (HPC) is a rare tumour often mistakenly repor ted as "vascular meningioma". Unlike meningiomas, HPC has a high rate of lo cal recurrence and distant metastases, which may occur several years after initial treatment. We report a patient in whom a HPC was misdiagnosed as be nign vascular meningioma and the patient discharged from follow-up. HPC was diagnosed 11 years later from biopsy of a skeletal metastasis. Histologica l review of the meningeal tumour confirmed the diagnosis of meningeal HPC. Meningeal HPCs resemble meningiomas clinically, radiologically and even lig ht microscopically. As a result, they can be reported as atypical meningiom a, as in this case. HPC's are more aggressive than typical meningiomas, wit h a high rate of recurrence and distant metastasis, often late in the cours e of the disease. Management of meningeal HPC differs from that of typical meningioma, with a need for post-operative radiotherapy and long-term follo w-up.