Chronic management and recurrent challenges: a case of multifocal spinal hemangiopericytoma over 7 years. Illustrative case.

Wahab Moustafa, Jörg Silbermann, Amr Badary, Salah Maksoud, Mohammad Khalil Al-Barbarawi
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Abstract

Background: Spinal hemangiopericytoma (sHPC) is a rare vascular tumor that presents significant challenges in diagnosis and management due to its potential for recurrence and metastasis.

Observations: This report documents the 7-year clinical course of a 68-year-old female diagnosed with multifocal sHPC. The patient initially presented with myelopathy due to a spinal mass, which was managed with resection, followed by several years of stability. Subsequent magnetic resonance imaging (MRI) revealed new growths, necessitating further interventions, including stereotactic radiosurgery. Despite the recurrence and progression of the disease, the strategic use of surgical and radiosurgical interventions demonstrated significant efficacy in managing tumor growth and alleviating symptoms.

Lessons: This case emphasizes the critical importance of continual surveillance and a multidisciplinary approach in the treatment of sHPC. Continuous monitoring through regular MRI is essential for early detection of recurrences. Adaptable treatment strategies, including resection and radiosurgery, are necessary to manage the complex dynamics of tumor behavior. This report also highlights the need for patient-centered care and flexible, individualized treatment plans to ensure optimal patient outcomes in the face of recurrent and multifocal disease manifestations. https://thejns.org/doi/10.3171/CASE24368.

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慢性管理和复发挑战:一例多灶性脊柱血管上皮细胞瘤,历时 7 年。示例病例。
背景:脊髓血管细胞瘤(sHPC)是一种罕见的血管肿瘤,由于其复发和转移的可能性,给诊断和治疗带来了巨大挑战:本报告记录了一名被诊断为多灶性 sHPC 的 68 岁女性的 7 年临床病程。患者最初因脊柱肿块而出现脊髓病变,经切除术治疗后,病情稳定数年。随后的磁共振成像(MRI)发现了新的生长点,因此有必要采取进一步的干预措施,包括立体定向放射外科手术。尽管疾病复发和进展,但外科手术和放射外科手术干预的策略性使用在控制肿瘤生长和缓解症状方面取得了显著疗效:本病例强调了持续监测和多学科方法在治疗 sHPC 中的极端重要性。通过定期磁共振成像进行持续监测对早期发现复发至关重要。包括切除术和放射外科手术在内的适应性治疗策略对于处理肿瘤行为的复杂动态变化十分必要。本报告还强调了以患者为中心的护理和灵活的个体化治疗计划的必要性,以确保患者在面对复发和多灶性疾病表现时获得最佳治疗效果。https://thejns.org/doi/10.3171/CASE24368。
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