Large haemangiopericytoma of the posterior cervical space. The role of imaging and therapeutic embolisation in the management of an unsuspected hypervascular head and neck neoplasm.

SUMMARY: We report a case of a 39-year old woman who upon developing a rapidly enlarging posterior cervical space tumour, underwent incisional biopsy prior to diagnostic imaging that resulted in nearly catastrophic haemorrhage. Subsequently, MR imaging showed evidence of marked hypervascularity, prompting diagnostic angiography and endovascular microembolization prior to surgical resection. The tumour turned out to be a large haemangiopericytoma arising from the paravertebral musculature. The case is instructive by highlighting the need for considering rare locations of hypervascular tumours in the head and neck region before attempting biopsy, which can be predicted by cross-sectional imaging studies, and the benefits of pre-operative devascularization with modern superselective microembolisation techniques.