Thirteen-year follow-up of parasellar intravascular papillary endothelial hyperplasia successfully treated by surgical excision: case report

J Neurosurg Pediatr. 2015 Apr;15(4):384-91. doi: 10.3171/2014.9.PEDS13518. Epub 2015 Jan 16.

Abstract

Intracranial intravascular papillary endothelial hyperplasia (IPEH) is very rare, and to our knowledge long-term follow-up results have not been previously published. An 11-year-old boy presented with a 6-month history of progressive visual impairment in the right eye. Magnetic resonance imaging revealed a well-enhanced, large parasellar mass involving the cavernous sinus, right frontal skull base, and ethmoid and sphenoid sinuses. Frontotemporal craniotomy and subtotal resection were performed, and the diagnosis of IPEH was confirmed. The mass increased in size during the following 3 months. A second operation was performed via frontotemporal craniotomy combined with a transsphenoidal approach, and gross-total resection of the tumor was achieved. Adjuvant radiotherapy (5040 cGy) and chemotherapy with interferon were administered. The patient's visual symptoms improved, and there was no recurrence during a 13-year follow-up period. The results of this case indicate that intracranial IPEH can recur with subtotal resection; however, optimal resection with multimodal adjuvant treatment can control the disease for many years, if not permanently.

Keywords: IPEH = intravascular papillary endothelial hyperplasia; hemangioendothelioma; intracranial tumor; intravascular papillary endothelial hyperplasia; oncology; vascular tumor.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Cavernous Sinus / pathology*
  • Chemotherapy, Adjuvant
  • Child
  • Craniotomy
  • Endothelium, Vascular / pathology*
  • Ethmoid Sinus / blood supply
  • Humans
  • Hyperplasia / diagnosis
  • Hyperplasia / etiology
  • Interferons / administration & dosage
  • Magnetic Resonance Imaging
  • Male
  • Neoplasms, Vascular Tissue / diagnosis*
  • Neoplasms, Vascular Tissue / pathology
  • Neoplasms, Vascular Tissue / surgery*
  • Orbit / blood supply*
  • Papilledema / etiology
  • Paranasal Sinus Neoplasms / complications
  • Paranasal Sinus Neoplasms / diagnosis*
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / surgery*
  • Radiotherapy, Adjuvant
  • Reoperation
  • Skull Base / blood supply
  • Sphenoid Sinus / blood supply
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vision Disorders / etiology*

Substances

  • Antineoplastic Agents
  • Interferons