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CASE REPORT Table of Contents   
Year : 2008  |  Volume : 14  |  Issue : 2  |  Page : 88-89
Hemangiopericytoma of greater omentum presenting as a huge abdominal lump


Department of Surgery, Agartala Government Medical College and G. B. Pant Hospital, Agartala, Tripura, India

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Date of Submission13-Oct-2007
Date of Acceptance07-Jan-2008
 

   Abstract 

Hemangiopericytoma is a rare neoplasm that can occur in any part of the human body, but it rarely develops in the greater omentum. We report a case of a patient who presented with a huge abdominal lump. At laparotomy, a huge vascular tumor, which was observed originating from the greater omentum, was resected. Histopathology investigation revealed this tumor as a benign hemangiopericytoma with a malignant potential.

Keywords: Greater omentum, hemangiopericytoma, laparotomy

How to cite this article:
Chatterjee D, Sarkar P, Sengupta N, Singh W G. Hemangiopericytoma of greater omentum presenting as a huge abdominal lump. Saudi J Gastroenterol 2008;14:88-9

How to cite this URL:
Chatterjee D, Sarkar P, Sengupta N, Singh W G. Hemangiopericytoma of greater omentum presenting as a huge abdominal lump. Saudi J Gastroenterol [serial online] 2008 [cited 2020 May 29];14:88-9. Available from: http://www.saudijgastro.com/text.asp?2008/14/2/88/39626


Hemangiopericytoma is a rare tumor featuring Zimmermann's pericytes, which was first described by Stout and Murry. [1] Pericytes are rudimentary cells that have contractile proteins that regulate blood flow through capillaries. Hemangiopericytoma develops in deep soft tissues, especially those of the extremities or retroperitoneum, and commonly affects middle-aged patients. [2] Development of this tumor in the greater omentum, according to the literature review, is very rare, as only 14 cases have been reported till date. [3] Tumor size is an important prognostic factor, and surgical resection provides the only chance of effective cure.


   Case Report Top


A 41-year-old male patient was admitted to the with a huge abdominal lump. Abdominal ultrasonography diagnosed it as a retroperitoneal tumor. Fine needle aspiration cytology (FNAC) described it as being mesenchymal in origin. During laparotomy, a huge, dark brown, lobulated mass weighing 470 g measuring 12.5 8.5 7.5 cm 3 was detected arising from the greater omentum [Figure - 1]. This mass was resected and sent for histopathological examination, which diagnosed it as hemangiopericytoma [Figure - 2]. The tumor was also positive for CD34. Recovery was uneventful and the patient was advised to visit the hospital for follow ups.


   Discussion Top


Hemangiopericytoma is a rare tumor featuring Zimmerman's pericytes, which was first described by Stout and Murry. [1] Hemangiopericytoma represent <1% of all vascular neoplasms. [4] This is a tumor of mesenchymal perivascular cell origin with dilated vascular spaces spread throughout the entire tumor. The tumor cells are surrounded by reticulin, and are negative for muscles, nerve sheaths and epithelial markers, and positive for CD34. [5] This tumor arising in the greater omentum is extremely rare and only a few cases (14 in number) were reported in the English literature. [6],[7],[8] Hypervascularity is a contraindication for FNAC, therefore a histopathological diagnosis was established after an excision. [4] A review of the reported cases suggests that surgical resection with subsequent radiotherapy provides the only chance of effective cure [4],[9] and revealed that three patients died of recurrence. Metastases occur by hematogenous and lymphogenous routes affecting mainly the liver, bones, and regional lymph nodes. Multiple hepatic and bone metastases 12 years after tumor resection have been reported. [4] Therefore, the evaluation of malignant potential is important. Recent reports proposed that malignant hemangiopericytoma should be suspected in cases where the tumor size is >5 cm. [6] Different studies suggest that surgical resection provides the only chance of effective cure and a tumor size of ≥20 cm predicts an unfavorable prognosis.[11]

 
   References Top

1.Stout AP, Murry MR. Haemangiopericytoma: A vascular tumour featuring Zimmermann's pinocytes. Ann Surg 1942;116:26-33.  Back to cited text no. 1    
2.Markku M, Sharon WW. Soft tissue tumours. Anderson's pathology. 10 th ed. Vol- 2. In : Ivan D, James L, editors. Mosby; Missouri (USA); 1996. p. 2501-2.  Back to cited text no. 2    
3.Shiba H, Misawa T, Kobayashi S, Yokota T, Son K, Yang K. Haemagiopericytoma of greater omentum. J Gastrointest Surg 2007;11:549-51.  Back to cited text no. 3    
4.Sleepski M, Piotrowiak I, Wlodarezyk Z. Local recurrence and distance metastases 18 years after resection of the greater omentum haemangiopericytoma. World J Surg Oncol 2007;63:1477-8.  Back to cited text no. 4    
5.Sternberg's diagnostic Surgical pathology, 3 rd ed, 1992-2004.  Back to cited text no. 5    
6.Imachi M, Tsukamoto N, Tsukimori, Funakoshi K, Nakano H, Shigematsu T, et al . Malignant haemangiopericytoma of omentum presenting as ovarian tumour. Gynaecol Oncol 1990;39:208-13.  Back to cited text no. 6    
7.Borgman U, Haidenrich W. Intrabdominal haemangiopericytoma: An unexpected finding during laparotomy. Zentralbl Gynakol 1999;121:153-5.  Back to cited text no. 7    
8.Piazza L, Ferrara F, Pulviranti A. Haemangiopericytoma of the greater omentum: Videolaparoscopic treatment: Case report and review of literature. Suppl Tumori 2005;4:128.  Back to cited text no. 8    
9.Kaneko K, Shirai Y, Wakai T, Hasegawa G, Kaneko I, Hatakeyama K. Haemangiopericytoma arising in the greater omentum: Report of a case. Surg Today 2003;33:722-4.  Back to cited text no. 9    
10.Rao SR, Rao RS, Sampat MB. Haemangiopericytoma of greater omentum: Report of a case. Indian J Gastroentrol 2000;19:33-5.  Back to cited text no. 10    
11.Bovino A, Basso L, Di Giacomo GD, Pisanelli MC, Basile U, De Toma D. Haemangiopericytoma of greater omentum: A rare case of acute abdominal pain. J Exp Clin Cancer Res 2003;22:649-50.  Back to cited text no. 11    

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Correspondence Address:
Damodar Chatterjee
FI-Gitanjali Apartments, HGB Road, Agartala - 799 001, Tripura
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.39626

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    Figures

  [Figure - 1], [Figure - 2]

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