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

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.