Endocrine Abstracts

Background: Hemangiopericytoma (HPC) is a malignant vasculary tumor originate from pericytes around the capillary and venules. İntracranial hemangiopericytomas usually arise from meninges, rarely they locate periventricular, suprasellar or sellar. Because of the malignancy potential, the differential diagnosis is important. A rare case of sellar HPC mimicking non-functional pituitary adenoma will be presented.

Case report: A 45 years old woman has admitted to our hospital complaining about two year’s ongoing amenorea, spontaneous galactorea and one month ongoing headache. Hypocortisolism was detected at the hormonal tests and ACTH stimulation test was performed. The hypocortisolism was verified and we gave steroid therapy to the patient. The other hormonal tests were normal. The 3×2 cm suprasellar, well demarcated, predominantly solid with multiple cystic areas mass lesion extending into the sellar was shown at the MRI images. Because of the sudden vision loss, the patient was operated as an emergency, the prediagnosis was pituitary apoplexia. Because of the bleeding, the mass could not been totally resected at the procedure. There was residual mass at the post-operative MRI images but the visual examination was improved postoperatively. Central hypothyroidism was seen after the operation so we gave the patient levotyhroxine therapy. The pathological diagnosis was HPC. The patient developed acute vision after 2 months, so another surgical procedure was performed. The pathological diagnosis was HPC again.

Discussion: HPC arising from central nervous system (CNS) form less than 1% of intracranial tumors and less than 2.5% of the meningeal tumors and are rarely diagnosed preoperatively. HPC relapses in many cases and metastasizes to other parts of the body. Because of the aggressivity of this tumor, it relapses locally even after total resection and metastasizes to CNS or other parts of the body. Patients that received radiotherapy (RT) have better local control, disease-free survival, and overall survival rates. İn selected cases chemotherapy can be discussed at the patients who had recurrence after RT.