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Spine
Diagnosis
Neoplasms, Cysts, and Other Masses
Neoplasms
Intradural Extramedullary
Solitary Fibrous Tumor/Hemangiopericytoma
Solitary Fibrous Tumor/Hemangiopericytoma
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Solitary fibrous tumor (SFT)
              • Hemangiopericytoma (HPC)

            • Definitions

              • Mesenchymal neoplasm composed of oval to spindle-shaped cells with prominent branching (HPC-like) vascular pattern
              • Bone
                • Most previously diagnosed HPCs of bone are now classified as SFTs
              • CNS
                • SFT/HPC terminology still utilized
                  • Considered to exist in spectrum
                    • Tumors previously considered SFTs represent lower end of spectrum with more indolent behavior
                    • Tumors previously considered HPCs in CNS represent higher end of spectrum with less favorable prognosis
                  • Most SFTs/HPCs harbor NAB2/STAT6 fusion

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. González-Vargas PM et al: Hemangiopericytoma/solitary fibrous tumor in the central nervous system. Experience with surgery and radiotherapy as a complementary treatment: a 10-year analysis of a heterogeneous series in a single tertiary center. Neurocirugia (Astur). 31(1):14-23, 2020
                                              2. Koeller KK et al: Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. radiographics. 39(2):468-90, 2019
                                              3. Li Z et al: Primary epidural hemangiopericytoma of the thoracic spine: case report and literature review. J Clin Neurosci. 60:142-7, 2019
                                              4. Chen H et al: Solitary fibrous tumor of the central nervous system: a clinicopathologic study of 24 cases. Acta Neurochir (Wien). 154(2):237-48, 2012
                                              5. Verbeke SL et al: A reappraisal of hemangiopericytoma of bone; analysis of cases reclassified as synovial sarcoma and solitary fibrous tumor of bone. Am J Surg Pathol. 34(6):777-83, 2010
                                              6. Fitzpatrick D et al: Intradural hemangiopericytoma of the lumbar spine: a rare entity. AJNR Am J Neuroradiol. 30(1):152-4, 2009
                                              7. Park MS et al: New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol. 21(4):327-31, 2009
                                              8. Kashiwazaki D et al: Subpial hemangiopericytoma with marked extramedullary growth: case report. Neurosurgery. 61(6):E1336-7; discussion E1337, 2007
                                              9. Gengler C et al: Solitary fibrous tumour and haemangiopericytoma: evolution of a concept. Histopathology. 48(1):63-74, 2006
                                              10. Cox DP et al: Myopericytoma of the thoracic spine: a case report. Spine. 28(2):E30-2, 2003
                                              11. Musacchio M et al: Posterior cervical haemangiopericytoma with intracranial and skull base extension. Diagnostic and therapeutic challenge of a rare hypervascular neoplasm. J Neuroradiol. 30(3):180-7, 2003
                                              12. Woitzik J et al: Delayed manifestation of spinal metastasis: a special feature of hemangiopericytoma. Clin Neurol Neurosurg. 105(3):159-66, 2003
                                              13. Akhaddar A et al: Thoracic epidural hemangiopericytoma. Case report. J Neurosurg Sci. 46(2):89-92; discussion 92, 2002
                                              14. Betchen S et al: Intradural hemangiopericytoma of the lumbar spine: case report. Neurosurgery. 50(3):654-7, 2002
                                              15. Ijiri K et al: Primary epidural hemangiopericytoma in the lumbar spine: a case report. Spine (Phila Pa 1976). 27(7):E189-92, 2002
                                              16. Tayoro K et al: [Imaging of meningeal hemangiopericytomas] J Radiol. 83(4 Pt 1):459-65, 2002
                                              17. Suzuki SO et al: Clinicopathological features of solitary fibrous tumor of the meninges: An immunohistochemical reappraisal of cases previously diagnosed to be fibrous meningioma or hemangiopericytoma. Pathol Int. 50(10):808-17, 2000
                                              18. Nonaka M et al: Metastatic meningeal hemangiopericytoma of thoracic spine. Clin Neurol Neurosurg. 100(3):228-30, 1998
                                              19. Lin YJ et al: Primary hemangiopericytoma in the axis bone: case report and review of literature. Neurosurgery. 39(2):397-9; discussion 399-400, 1996
                                              20. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995
                                              21. Kozlowski K et al: Primary sacral bone tumours in children (report of 16 cases with a short literature review). Australas Radiol. 34(2):142-9, 1990
                                              22. Bridges LR et al: Haemangiopericytic meningioma of the sacral canal: a case report. J Neurol Neurosurg Psychiatry. 51(2):288-90, 1988
                                              23. Cuccurullo L et al: Hemangiopericytoma of the cervical spine. A case report. Acta Neurol (Napoli). 6(6):472-81, 1984
                                              24. Beadle GF et al: Treatment of advanced malignant hemangiopericytoma with combination adriamycin and DTIC: a report of four cases. J Surg Oncol. 22(3):167-70, 1983
                                              25. Muraszko KM et al: Hemangiopericytomas of the spine. Neurosurgery. 10(4):473-9, 1982
                                              26. Cappabianca P et al: Hemangiopericytoma of the spinal canal. Surg Neurol. 15(4):298-302, 1981
                                              27. Anderson C et al: Skeletal metastases of an intracranial malignant hemangiopericytoma. Report of a case. J Bone Joint Surg Am. 62(1):145-8, 1980
                                              28. Stern MB et al: Hemangiopericytoma of the cervical spine: report of an unusual case. Clin Orthop. (151):201-4, 1980
                                              29. Subbarao K et al: Primary malignant neoplasms. Semin Roentgenol. 14(1):44-57, 1979
                                              30. Harris DJ et al: Hemangiopericytoma of the spinal canal. Report of three cases. J Neurosurg. 49(6):914-20, 1978
                                              31. Hart S et al: Haemangiopericytoma of the pre-sacral space. Br J Surg. 60(7):583-4, 1973
                                              32. Baxter PJ et al: Haemangiopericytoma. Light and electron microscopy studies of a cerebral secondary tumour. Acta Neuropathol (Berl). 21(3):253-7, 1972
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Solitary fibrous tumor (SFT)
                                                          • Hemangiopericytoma (HPC)

                                                        • Definitions

                                                          • Mesenchymal neoplasm composed of oval to spindle-shaped cells with prominent branching (HPC-like) vascular pattern
                                                          • Bone
                                                            • Most previously diagnosed HPCs of bone are now classified as SFTs
                                                          • CNS
                                                            • SFT/HPC terminology still utilized
                                                              • Considered to exist in spectrum
                                                                • Tumors previously considered SFTs represent lower end of spectrum with more indolent behavior
                                                                • Tumors previously considered HPCs in CNS represent higher end of spectrum with less favorable prognosis
                                                              • Most SFTs/HPCs harbor NAB2/STAT6 fusion

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Angiographic Findings

                                                                  • Nonvascular Interventions

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          Selected References

                                                                                          1. González-Vargas PM et al: Hemangiopericytoma/solitary fibrous tumor in the central nervous system. Experience with surgery and radiotherapy as a complementary treatment: a 10-year analysis of a heterogeneous series in a single tertiary center. Neurocirugia (Astur). 31(1):14-23, 2020
                                                                                          2. Koeller KK et al: Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. radiographics. 39(2):468-90, 2019
                                                                                          3. Li Z et al: Primary epidural hemangiopericytoma of the thoracic spine: case report and literature review. J Clin Neurosci. 60:142-7, 2019
                                                                                          4. Chen H et al: Solitary fibrous tumor of the central nervous system: a clinicopathologic study of 24 cases. Acta Neurochir (Wien). 154(2):237-48, 2012
                                                                                          5. Verbeke SL et al: A reappraisal of hemangiopericytoma of bone; analysis of cases reclassified as synovial sarcoma and solitary fibrous tumor of bone. Am J Surg Pathol. 34(6):777-83, 2010
                                                                                          6. Fitzpatrick D et al: Intradural hemangiopericytoma of the lumbar spine: a rare entity. AJNR Am J Neuroradiol. 30(1):152-4, 2009
                                                                                          7. Park MS et al: New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol. 21(4):327-31, 2009
                                                                                          8. Kashiwazaki D et al: Subpial hemangiopericytoma with marked extramedullary growth: case report. Neurosurgery. 61(6):E1336-7; discussion E1337, 2007
                                                                                          9. Gengler C et al: Solitary fibrous tumour and haemangiopericytoma: evolution of a concept. Histopathology. 48(1):63-74, 2006
                                                                                          10. Cox DP et al: Myopericytoma of the thoracic spine: a case report. Spine. 28(2):E30-2, 2003
                                                                                          11. Musacchio M et al: Posterior cervical haemangiopericytoma with intracranial and skull base extension. Diagnostic and therapeutic challenge of a rare hypervascular neoplasm. J Neuroradiol. 30(3):180-7, 2003
                                                                                          12. Woitzik J et al: Delayed manifestation of spinal metastasis: a special feature of hemangiopericytoma. Clin Neurol Neurosurg. 105(3):159-66, 2003
                                                                                          13. Akhaddar A et al: Thoracic epidural hemangiopericytoma. Case report. J Neurosurg Sci. 46(2):89-92; discussion 92, 2002
                                                                                          14. Betchen S et al: Intradural hemangiopericytoma of the lumbar spine: case report. Neurosurgery. 50(3):654-7, 2002
                                                                                          15. Ijiri K et al: Primary epidural hemangiopericytoma in the lumbar spine: a case report. Spine (Phila Pa 1976). 27(7):E189-92, 2002
                                                                                          16. Tayoro K et al: [Imaging of meningeal hemangiopericytomas] J Radiol. 83(4 Pt 1):459-65, 2002
                                                                                          17. Suzuki SO et al: Clinicopathological features of solitary fibrous tumor of the meninges: An immunohistochemical reappraisal of cases previously diagnosed to be fibrous meningioma or hemangiopericytoma. Pathol Int. 50(10):808-17, 2000
                                                                                          18. Nonaka M et al: Metastatic meningeal hemangiopericytoma of thoracic spine. Clin Neurol Neurosurg. 100(3):228-30, 1998
                                                                                          19. Lin YJ et al: Primary hemangiopericytoma in the axis bone: case report and review of literature. Neurosurgery. 39(2):397-9; discussion 399-400, 1996
                                                                                          20. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995
                                                                                          21. Kozlowski K et al: Primary sacral bone tumours in children (report of 16 cases with a short literature review). Australas Radiol. 34(2):142-9, 1990
                                                                                          22. Bridges LR et al: Haemangiopericytic meningioma of the sacral canal: a case report. J Neurol Neurosurg Psychiatry. 51(2):288-90, 1988
                                                                                          23. Cuccurullo L et al: Hemangiopericytoma of the cervical spine. A case report. Acta Neurol (Napoli). 6(6):472-81, 1984
                                                                                          24. Beadle GF et al: Treatment of advanced malignant hemangiopericytoma with combination adriamycin and DTIC: a report of four cases. J Surg Oncol. 22(3):167-70, 1983
                                                                                          25. Muraszko KM et al: Hemangiopericytomas of the spine. Neurosurgery. 10(4):473-9, 1982
                                                                                          26. Cappabianca P et al: Hemangiopericytoma of the spinal canal. Surg Neurol. 15(4):298-302, 1981
                                                                                          27. Anderson C et al: Skeletal metastases of an intracranial malignant hemangiopericytoma. Report of a case. J Bone Joint Surg Am. 62(1):145-8, 1980
                                                                                          28. Stern MB et al: Hemangiopericytoma of the cervical spine: report of an unusual case. Clin Orthop. (151):201-4, 1980
                                                                                          29. Subbarao K et al: Primary malignant neoplasms. Semin Roentgenol. 14(1):44-57, 1979
                                                                                          30. Harris DJ et al: Hemangiopericytoma of the spinal canal. Report of three cases. J Neurosurg. 49(6):914-20, 1978
                                                                                          31. Hart S et al: Haemangiopericytoma of the pre-sacral space. Br J Surg. 60(7):583-4, 1973
                                                                                          32. Baxter PJ et al: Haemangiopericytoma. Light and electron microscopy studies of a cerebral secondary tumour. Acta Neuropathol (Berl). 21(3):253-7, 1972