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Solitary Fibrous Tumor/Hemangiopericytoma
Karen L. Salzman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Hemangiopericytoma (HPC), meningeal hemangiopericytoma, meningeal solitary fibrous tumor
              • Synonyms

                • In older literature called "angioblastic meningioma," hemangiopericytic type
                • New literature supports terms solitary fibrous tumor (SFT) or hemangiopericytoma (HPC)
              • Definitions

                • Mesenchymal tumor of fibroblastic type, often with rich branching vascular pattern, including spectrum of tumors previously classified as meningeal SFT and HPC
                • SFT/HPC of CNS nearly always attached to dura
                • Occur in any region of body where capillaries are found

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Chen T et al: Differentiating intracranial solitary fibrous tumor/hemangiopericytoma from meningioma using diffusion-weighted imaging and susceptibility-weighted imaging. Neuroradiology. 62(2):175-84, 2020
                                                2. He W et al: Whole-tumor histogram analysis of apparent diffusion coefficient in differentiating intracranial solitary fibrous tumor/hemangiopericytoma from angiomatous meningioma. Eur J Radiol. 112:186-91, 2019
                                                3. Koeller KK et al: Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. radiographics. 39(2):468-90, 2019
                                                4. Wang J et al: Solitary fibrous tumor/hemangiopericytoma of spinal cord: A retrospective single-center study of 16 cases. World Neurosurg. 123:e629-38, 2019
                                                5. Kinslow CJ et al: Solitary-fibrous tumor/hemangiopericytoma of the central nervous system: a population-based study. J Neurooncol. 138(1):173-82, 2018
                                                6. Ratneswaren T et al: Surveillance for metastatic hemangiopericytoma-solitary fibrous tumors-systematic literature review on incidence, predictors and diagnosis of extra-cranial disease. J Neurooncol. 138(3):447-67, 2018
                                                7. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                                8. Louis DN et al: WHO Classification of Tumours of the Central Nervous System: Mesenchymal, non-meningothelial tumours. IARC Press. 248-54, 2016
                                                9. Nakada S et al: NAB2-STAT6 fusion gene analysis in two cases of meningeal solitary fibrous tumor/hemangiopericytoma with late distant metastases. Brain Tumor Pathol. ePub, 2015
                                                10. Damodaran O et al: Primary intracranial haemangiopericytoma: comparison of survival outcomes and metastatic potential in WHO grade II and III variants. J Clin Neurosci. 21(8):1310-4, 2014
                                                11. Ghose A et al: CNS hemangiopericytoma: A systematic review of 523 patients. Am J Clin Oncol. ePub, 2014
                                                12. Liu L et al: Comparison of ADC values of intracranial hemangiopericytomas and angiomatous and anaplastic meningiomas. J Neuroradiol. 41(3):188-94, 2014
                                                13. McHugh BJ et al: Intracranial infantile hemangiopericytoma. J Neurosurg Pediatr. 14(2):149-54, 2014
                                                14. Smith AB et al: From the radiologic pathology archives: mass lesions of the dura: beyond meningioma-radiologic-pathologic correlation. Radiographics. 34(2):295-312, 2014
                                                15. Sonabend AM et al: The role for adjuvant radiotherapy in the treatment of hemangiopericytoma: a Surveillance, Epidemiology, and End Results analysis. J Neurosurg. 120(2):300-8, 2014
                                                16. Liu G et al: Intracranial hemangiopericytoma: MR imaging findings and diagnostic usefulness of minimum ADC values. J Magn Reson Imaging. 38(5):1146-51, 2013
                                                17. Tian R et al: Clinical characteristics and prognostic analysis of recurrent hemangiopericytoma in the central nervous system: a review of 46 cases. J Neurooncol. 115(1):53-9, 2013
                                                18. Chernov MF et al: Possible role of single-voxel (1)H-MRS in differential diagnosis of suprasellar tumors. J Neurooncol. 91(2):191-8, 2009
                                                19. Fitzpatrick D et al: Intradural hemangiopericytoma of the lumbar spine: a rare entity. AJNR Am J Neuroradiol. 30(1):152-4, 2009
                                                20. Hayashi Y et al: A reevaluation of the primary diagnosis of hemangiopericytoma and the clinical importance of differential diagnosis from solitary fibrous tumor of the central nervous system. Clin Neurol Neurosurg. 111(1):34-8, 2009
                                                21. Park MS et al: New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol. 21(4):327-31, 2009
                                                22. Shi ZP et al: Multiple metastatic progression of meningeal hemangiopericytoma initially diagnosed as atypical meningioma with temporal bone invasion. Otolaryngol Head Neck Surg. 140(2):278-80, 2009
                                                23. Wu W et al: Hemangiopericytomas in the central nervous system. J Clin Neurosci. 16(4):519-23, 2009
                                                24. Chamberlain MC et al: Sequential salvage chemotherapy for recurrent intracranial hemangiopericytoma. Neurosurgery. 63(4):720-6; author reply 726-7, 2008
                                                25. Jalali R et al: Suprasellar haemangiopericytoma--challenges in diagnosis and treatment. Acta Neurochir (Wien). 150(1):67-71, 2008
                                                26. Mathews MS et al: Klippel-Trenaunay syndrome and cerebral haemangiopericytoma: a potential association. Acta Neurochir (Wien). 150(4):399-402; discussion 402, 2008
                                                27. Mekni A et al: Hemangiopericytoma in the central nervous system. A study of eight cases. Neurochirurgie. 54(1):15-20, 2008
                                                28. Scheithauer BW et al: The 2007 WHO classification of tumors of the nervous system: controversies in surgical neuropathology. Brain Pathol. 2008 Jul;18(3):307-16. Erratum in: Brain Pathol. 18(4):640, 2008
                                                29. Juco J et al: Hemangiopericytoma of the sella mimicking pituitary adenoma: case report and review of the literature. Clin Neuropathol. 26(6):288-93, 2007
                                                30. Sibtain NA et al: Imaging features of central nervous system haemangiopericytomas. Eur Radiol. 17(7):1685-93, 2007
                                                31. Lee JK et al: Spinal metastasis from cranial meningeal hemangiopericytomas. Acta Neurochir (Wien). 148(7):787-90, 2006
                                                32. Folpe AL et al: Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol. 28(1):1-30, 2004
                                                33. Ecker RD et al: Hemangiopericytoma in the central nervous system: treatment, pathological features, and long-term follow up in 38 patients. J Neurosurg. 98(6):1182-7, 2003
                                                34. Kim JH et al: Meningeal hemangiopericytomas: long-term outcome and biological behavior. Surg Neurol. 59(1):47-53; discussion 53-4, 2003
                                                35. Burger PC et al: Surgical pathology of the nervous system and its coverings: Intracranial meninges. 4th ed. Philadelphia: Churchill Livingstone. 79-83, 2002
                                                36. Barba I et al: Magnetic resonance spectroscopy of brain hemangiopericytomas: high myoinositol concentrations and discrimination from meningiomas. J Neurosurg. 94(1):55-60, 2001
                                                37. Huisman TA et al: Meningeal hemangiopericytoma in childhood. Eur Radiol. 10(7):1073-5, 2000
                                                38. Kracht LW et al: Positron emission tomography in a case of intracranial hemangiopericytoma. J Comput Assist Tomogr. 23(3):365-8, 1999
                                                39. Spitz FR et al: Hemangiopericytoma: a 20-year single-institution experience. Ann Surg Oncol. 5(4):350-5, 1998
                                                40. Chiechi MV et al: Intracranial hemangiopericytomas: MR and CT features. AJNR Am J Neuroradiol. 17(7):1365-71, 1996
                                                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

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Hemangiopericytoma (HPC), meningeal hemangiopericytoma, meningeal solitary fibrous tumor
                                                            • Synonyms

                                                              • In older literature called "angioblastic meningioma," hemangiopericytic type
                                                              • New literature supports terms solitary fibrous tumor (SFT) or hemangiopericytoma (HPC)
                                                            • Definitions

                                                              • Mesenchymal tumor of fibroblastic type, often with rich branching vascular pattern, including spectrum of tumors previously classified as meningeal SFT and HPC
                                                              • SFT/HPC of CNS nearly always attached to dura
                                                              • Occur in any region of body where capillaries are found

                                                            IMAGING

                                                            • General Features

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Angiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Chen T et al: Differentiating intracranial solitary fibrous tumor/hemangiopericytoma from meningioma using diffusion-weighted imaging and susceptibility-weighted imaging. Neuroradiology. 62(2):175-84, 2020
                                                                                              2. He W et al: Whole-tumor histogram analysis of apparent diffusion coefficient in differentiating intracranial solitary fibrous tumor/hemangiopericytoma from angiomatous meningioma. Eur J Radiol. 112:186-91, 2019
                                                                                              3. Koeller KK et al: Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. radiographics. 39(2):468-90, 2019
                                                                                              4. Wang J et al: Solitary fibrous tumor/hemangiopericytoma of spinal cord: A retrospective single-center study of 16 cases. World Neurosurg. 123:e629-38, 2019
                                                                                              5. Kinslow CJ et al: Solitary-fibrous tumor/hemangiopericytoma of the central nervous system: a population-based study. J Neurooncol. 138(1):173-82, 2018
                                                                                              6. Ratneswaren T et al: Surveillance for metastatic hemangiopericytoma-solitary fibrous tumors-systematic literature review on incidence, predictors and diagnosis of extra-cranial disease. J Neurooncol. 138(3):447-67, 2018
                                                                                              7. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                                                                              8. Louis DN et al: WHO Classification of Tumours of the Central Nervous System: Mesenchymal, non-meningothelial tumours. IARC Press. 248-54, 2016
                                                                                              9. Nakada S et al: NAB2-STAT6 fusion gene analysis in two cases of meningeal solitary fibrous tumor/hemangiopericytoma with late distant metastases. Brain Tumor Pathol. ePub, 2015
                                                                                              10. Damodaran O et al: Primary intracranial haemangiopericytoma: comparison of survival outcomes and metastatic potential in WHO grade II and III variants. J Clin Neurosci. 21(8):1310-4, 2014
                                                                                              11. Ghose A et al: CNS hemangiopericytoma: A systematic review of 523 patients. Am J Clin Oncol. ePub, 2014
                                                                                              12. Liu L et al: Comparison of ADC values of intracranial hemangiopericytomas and angiomatous and anaplastic meningiomas. J Neuroradiol. 41(3):188-94, 2014
                                                                                              13. McHugh BJ et al: Intracranial infantile hemangiopericytoma. J Neurosurg Pediatr. 14(2):149-54, 2014
                                                                                              14. Smith AB et al: From the radiologic pathology archives: mass lesions of the dura: beyond meningioma-radiologic-pathologic correlation. Radiographics. 34(2):295-312, 2014
                                                                                              15. Sonabend AM et al: The role for adjuvant radiotherapy in the treatment of hemangiopericytoma: a Surveillance, Epidemiology, and End Results analysis. J Neurosurg. 120(2):300-8, 2014
                                                                                              16. Liu G et al: Intracranial hemangiopericytoma: MR imaging findings and diagnostic usefulness of minimum ADC values. J Magn Reson Imaging. 38(5):1146-51, 2013
                                                                                              17. Tian R et al: Clinical characteristics and prognostic analysis of recurrent hemangiopericytoma in the central nervous system: a review of 46 cases. J Neurooncol. 115(1):53-9, 2013
                                                                                              18. Chernov MF et al: Possible role of single-voxel (1)H-MRS in differential diagnosis of suprasellar tumors. J Neurooncol. 91(2):191-8, 2009
                                                                                              19. Fitzpatrick D et al: Intradural hemangiopericytoma of the lumbar spine: a rare entity. AJNR Am J Neuroradiol. 30(1):152-4, 2009
                                                                                              20. Hayashi Y et al: A reevaluation of the primary diagnosis of hemangiopericytoma and the clinical importance of differential diagnosis from solitary fibrous tumor of the central nervous system. Clin Neurol Neurosurg. 111(1):34-8, 2009
                                                                                              21. Park MS et al: New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol. 21(4):327-31, 2009
                                                                                              22. Shi ZP et al: Multiple metastatic progression of meningeal hemangiopericytoma initially diagnosed as atypical meningioma with temporal bone invasion. Otolaryngol Head Neck Surg. 140(2):278-80, 2009
                                                                                              23. Wu W et al: Hemangiopericytomas in the central nervous system. J Clin Neurosci. 16(4):519-23, 2009
                                                                                              24. Chamberlain MC et al: Sequential salvage chemotherapy for recurrent intracranial hemangiopericytoma. Neurosurgery. 63(4):720-6; author reply 726-7, 2008
                                                                                              25. Jalali R et al: Suprasellar haemangiopericytoma--challenges in diagnosis and treatment. Acta Neurochir (Wien). 150(1):67-71, 2008
                                                                                              26. Mathews MS et al: Klippel-Trenaunay syndrome and cerebral haemangiopericytoma: a potential association. Acta Neurochir (Wien). 150(4):399-402; discussion 402, 2008
                                                                                              27. Mekni A et al: Hemangiopericytoma in the central nervous system. A study of eight cases. Neurochirurgie. 54(1):15-20, 2008
                                                                                              28. Scheithauer BW et al: The 2007 WHO classification of tumors of the nervous system: controversies in surgical neuropathology. Brain Pathol. 2008 Jul;18(3):307-16. Erratum in: Brain Pathol. 18(4):640, 2008
                                                                                              29. Juco J et al: Hemangiopericytoma of the sella mimicking pituitary adenoma: case report and review of the literature. Clin Neuropathol. 26(6):288-93, 2007
                                                                                              30. Sibtain NA et al: Imaging features of central nervous system haemangiopericytomas. Eur Radiol. 17(7):1685-93, 2007
                                                                                              31. Lee JK et al: Spinal metastasis from cranial meningeal hemangiopericytomas. Acta Neurochir (Wien). 148(7):787-90, 2006
                                                                                              32. Folpe AL et al: Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol. 28(1):1-30, 2004
                                                                                              33. Ecker RD et al: Hemangiopericytoma in the central nervous system: treatment, pathological features, and long-term follow up in 38 patients. J Neurosurg. 98(6):1182-7, 2003
                                                                                              34. Kim JH et al: Meningeal hemangiopericytomas: long-term outcome and biological behavior. Surg Neurol. 59(1):47-53; discussion 53-4, 2003
                                                                                              35. Burger PC et al: Surgical pathology of the nervous system and its coverings: Intracranial meninges. 4th ed. Philadelphia: Churchill Livingstone. 79-83, 2002
                                                                                              36. Barba I et al: Magnetic resonance spectroscopy of brain hemangiopericytomas: high myoinositol concentrations and discrimination from meningiomas. J Neurosurg. 94(1):55-60, 2001
                                                                                              37. Huisman TA et al: Meningeal hemangiopericytoma in childhood. Eur Radiol. 10(7):1073-5, 2000
                                                                                              38. Kracht LW et al: Positron emission tomography in a case of intracranial hemangiopericytoma. J Comput Assist Tomogr. 23(3):365-8, 1999
                                                                                              39. Spitz FR et al: Hemangiopericytoma: a 20-year single-institution experience. Ann Surg Oncol. 5(4):350-5, 1998
                                                                                              40. Chiechi MV et al: Intracranial hemangiopericytomas: MR and CT features. AJNR Am J Neuroradiol. 17(7):1365-71, 1996