PTU - Polskie Towarzystwo Urologiczne
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CODE: 21 - Tu retroperitonealis-hemangiopericytoma - case report
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Tomasz Stachowski 1, Zbigniew Kwias 2, Patryk Gmerek 1, Piotr Milecki 3, Ryszard Szpera 1, Włodzimierz Kowalczyk 1, Tomasz Piernik 1, Tomasz Deja 1
1 Oddział Urologii Szpitala MSWiA w Poznaniu
2 Klinika Urologii AM w Poznaniu
3 Wielkopolskie Centrum Onkologii w Poznaniu

summary

Introduction. Hemangiopericytoma is a malignant or benign vascular tumor that rarely occurs as a primary intraosseous lesion. The tumor is found most often in the skeletal system, mostly in the pelvis, proximal femur, vertebrae and humerus but can occur anywhere, olso in the retroperitoneum. Hemangiopericytomas occur most commonly during the fourth and fifth decade but affect patients age 12 to 90. Clinically, hemangiopericytomas may present with pain or a mass. The lesions grow slowly so it may be twenty years before a diagnosis is made. Hemangiopericytomas have almost no distinguishing characteristics radiologically. They may be lytic or cause focal sclerosis or they may have a honeycomb or reticular pattern- CT scan and MRI. Angiography shows spider-like radial branching vessels (the branching vascular channels of varying sizes is often described as a "staghorn" pattern). On gross examination, hemangiopericytomas may be well circumscribed and appear grayish white. The consistency is variable and may be solid or spongy, friable or granular. Hemangiopericytoma is a tumor thought to be derived from pericytes. The tumor cells are basophilic spindle shaped mononuclear cells that look like smooth muscle cells. The tumor cells do not arise from endothelial cells even though they surround irregular vascular spaces.
Objectives. This study is a case raport, it's purpose is to estimate the long-term results of the treatment in comparison with world literature.
Materials and methods. 56 years old man was advised in 2004 to the Urological Ward because of the tumor of right suprarenal. The suprarenal tumor was identified in the ultrasound. Computer tomography examination was performed respectively. The CT revealed well marginated, inhomogeneous mass, 7.7cm on 6.6 cm localised above the upper pole of the right kidney, in the localization responding the right suprarenalis. The mass was contrastic increased. The left kidney was of correct size and shape, without focal changes. The size of the left suprarenal was correct. The other abdominal organs were without focal changes in the computer tomography. Surgical procedure on the right suprarenal was performed. The aim of the operation was to preparate the tumor located above the upper kidney pole. The tumor was well demarcated and had it's own capsule. During the operation the 7cm in diameter tumor could be removed without rupture of the capsule. There was no harm made to the right kidney.
Results. Histopathology revealed: Neoplasma malignum angiogenes - haemangiopericytoma recidivans. Disseminatio neoplasmatica in peritoneo appendicis vermicularis. Postoperative radiotherapy was inducted (43.2 Gy/T) in Depatrment of Radiotheraphy in "Wielkopolskie Centrum Onkologii". Six and twelve mouth after operation the patient was again admitted to our hospital to perform a control CT. There was no masses which was in the previous examinations.A 39 x 24 mm hypodensic focal lesion was found in the liver, three hypodensic lesions 32 mm and 40 mm intraperitoneal close to the abdominal wall. The following cure and control are in the Oncology Centrum in Posen.
Conclusions. The tumors with hemangiopericytoma of the peritoneum are rare. The tumor is found most often in the skeletal system, mostly in the pelvis, proximal femur, vertebrae and humerus but can occur anywhere, olso in the retroperitoneum, and these masses could imitationed the tumors of the kidney. The cured are based on the surgical resection of the masses and postoperationem radiotheraphy. The monitoring after surgical operation is based on the systematic computer tomography each 6 mouth and adjuvant telethraphy.