Massive pulmonary hemangiopericytoma. An innovative approach to evaluation and treatment.

The authors report the case of a 39-year-old woman with a massive malignant pulmonary hemangiopericytoma. The clinical presentation and histologic findings were typical of this rare entity, but workup and treatment were challenging because of the size and location of the tumor. Magnetic resonance imaging (MRI) proved to be critical in the preoperative evaluation because of its unique ability to delineate the precise anatomical extent of this highly vascular neoplasm. Previous treatment of this patient with exploratory thoracotomy and chemotherapy had been unsuccessful. The authors used an innovative approach to treatment which included complete surgical resection via combined median sternotomy and thoracotomy, along with intraoperative and postoperative radiotherapy. The patient is disease-free 28 months after surgery.