Last Updated: March 27, 2020
- Highly vascular, hypercellular meningeal mesenchymal tumor
- Fibroblastic sarcoma
- Synonymous with “solitary fibrous tumor, hemangiocytoma type”
- WHO grade II or III (anaplastic)
- Arises from smooth muscle pericytes around meningeal capillaries
- “Staghorn” pattern of malignant cells surrounding blood vessels
- Hypercellular, increased mitotic index (Ki-67 5-10%)
- Markedly increased mitoses, necrosis in WHO grade III tumors
- More aggressive than meningiomas
- Anaplastic tumors have a tendency for systemic metastases
- Adults most commonly afflicted (4th-6th decades of life)
- Slight male gender predilection
- Common presenting signs/symptoms: headache
- Treatment: surgical resection ± pre-surgical embolization due to risk of intra-operative hemorrhage, chemotherapy, XRT
- Long-term patient monitoring due to delayed local recurrence, metastases
- Prognosis: 5-year survival >90%
- Lobulated, enhancing extra-axial mass with dural attachment (dural tail)
- Mimics meningioma but lacks calcification or adjacent calvarial hyperostosis
- Dural sinus invasion, calvarial erosion may be seen
- Hyperdense extra-axial mass
- Hypodense peritumoral edema
- ± Calvarial erosion
- Heterogeneous, but avid enhancement on contrast-enhanced CT
- T1WI: heterogeneous signal, ± flow voids
- T2WI: heterogeneous signal, hyperintense peritumoral edema, ± flow voids
- T1WI+C: heterogeneous but avid enhancement, ± dural tail
- MRV: ± dural venous sinus invasion/occlusion
- MRI without and with IV contrast; CT to help characterize calvarial invasion
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Rachel Seltman, MD
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Liu G, et al. Intracranial hemangiopericytoma: MR imaging findings and diagnostic usefulness of minimum ADC values. J Magn Reson Imaging. 2013;38:1146-1151.
Louis DN, et al. WHO Classification of Tumours of the CNS: Haemangiopericytoma. Lyon: IARC Press, 2007; 178-180.
Osborn AG, Salzman, KL, Jhaveri MD. Diagnostic Imaging (3rd ed). Philadelphia, PA: Elsevier, 2016.
Sibtain NA, et al. Imaging features of central nervous system haemangiopericytomas. Eur Radiol. 2007;17:1685-1693.
Smith AB, et al. From the radiologic pathology archives: mass lesions of the dura: beyond meningioma-radiologic-pathologic correlation. Radiographics. 2014;34:295-312.
Wu W, et al. Hemangiopericytomas in the central nervous system. J Clin Neurosci. 2009;16:519-523.
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