Ankara Üniversitesi Tıp Fakültesi Mecmuası 2008, 61(3) CERRAHİ BİLİMLER / SURGICAL SCIENCES Olgu Sunumu / Case Report Recurrent Hemangiopericytoma With Multiple Extracranial Metastates: A Case Report Multiple Ekstrakranial Metastazı olan Rekürren Hemanjioperisitoma: Olgu Sunumu Kutsal Devrim Seçinti, Gökmen Kahiloğulları, Hakan Tuna, Yusuf Şükrü Çağlar Ankara Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı 162 Received: 08.12.2008 • Accepted: 12.01.2008 Corresponding author Dr. Kutsal Devrim Seçinti Ankara Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı Phone : + 90 (312) 508 25 98/2793 E-mail address : devrimsecinti@yahoo.com Hemangiopericytoma is an uncommon, highly vascular tumor of pericyte origin that may occur anywhere capillaries are found. These tumors are usually located in the musculoskeletal system, retroperitoneum and the skin. Their intracranial localization is rare. Hemangiopericytomas have a predilection for both local and distant central nervous system recurrences and exhibit an incre- ased tendency to metastasize compared with nonmalignant meningiomas. The biological beha- vior of hemangiopericytoma is sometimes malignant although it is considered grade II-III. Local tumor recurrence after many years is not uncommon, and late and widespread extracranial me- tastases may occur although this is rare in other intracranial tumors. A 46-year old male who had a recurrent intracranial hemangiopericytoma with multiple metastases such as cervical vertebrae, paravertebral soft tissue, lung, kidney and shoulder has been reported. Key Words: Hemangiopericytoma, Meningioma, Extracranial metas, Recurrence Hemanjiyoperisitomalar nadir görülen, oldukça vasküler, kapiller damarların bulunduğu her yer- de görülebilen perisit orijinli tümörlerdir. Bu tümörler genelde kas iskelet sisteminde yerleşirler. Intrakranial yarleşimleri oldukça nadirdir. Hem local hem de santral sinir sisteminin uzak bölgele- rinde rekürrens yapmaya meyillidirler ve malign olmayan menenjiyomlara kıyasla uzak metastaz yapma ihtimalleri daha fazladır. Hemanjiyoperisitomların biyolojik davranışları bazen grade II-III olarak sınıfandırılmalarına neden olacak kadar malign olabilmektedir. Uzun yıllar sonra lokal tü- mor rekürrensi çok sık değildir ancak yaygın ekstrakranial metastaza rastlanabilmektedir. Bu yazı- da, servikal vertebra, paravertebral yumuşak doku, akciğer, böbrek ve kas-iskelet sistemi metastazı olan, aynı zamanda da intracranial rekürrensi olan bir hemanjiyoperisitom olgusu sunulmuştur. Anahtar Kelimeler: Hemanjioperisitom, Menenjiom, Ekstrakranial metastaz, Rekürrens Hemangiopericytoma (HPC) is an un- common, highly vascular tumor of pericyte origin that may occur any- where capillaries are found and it accounts for only 1.6-2.4 % of meningeal tumors and less than 1 % of all intracranial tumors (1-5). HPCs are usually located in the musculoskeletal system (lower ex- tremities, pelvis, vertebrae), retro- peritoneum and the skin, but they have been reported in the larynx, spleen, lung, kidney, pancreas, me- diastinium, orbita, adrenal gland, lymph nodes, liver, bone, breast, and pleura. Intracranial and to the other region metastasis of HPC is seen very rare together (6-8). In this report, we describe a patient with hemangiopericytoma to the other side of brain and a large me- tastasis to the cervicothoracic spine and humerus which occurred with a delay of 4 years after the removal of right frontal meningeal HPC. Case Report The patient, a 46-year old male, had undergone surgery for the removal of right sided anterior cranial fossa tumor with invasion of right cav- ernous sinus (Figure 1A, 1B). At that time, he had diplopia, head-