Hemangiopericytoma of the bone is a tumor or neoplasm that comes from the cells present at the walls of capillaries (tiny blood vessels).
Hemangiopericytomas are cancerous aggressive tumors that, if left unchecked, will grow and destroy your normal bone. Clinically, local pain and swelling may be the first signs. As the tumor slowly grows, the bone is weakened and you are at an increased risk of breaking the bone due to the tumor (called a pathological fracture). They may also spread to your lungs or other bones.
Radiographic imaging is used to help form a diagnosis. These include X-Ray, MRI, CT and Bone Scans.
An example of an MRI is shown.
Due to its rarity, there are no guidelines for its optimal treatment. Treatment should be aggressive and individualized. Treatment usually involves surgical removal and chemotherapy. Most patients are treated with a combination of surgery and chemotherapy. Most common treatment is wide radical limb sparing surgery. There are two kinds: round cell variation and hemangiopericytoma-like variation. Treatment for round cell variation includes a combination of chemotherapy, radiation and wide surgical resection. And for hemangiopericytoma-like variation includes chemotherapy and wide surgical resection only without radiation.
Intralesional Curettage means to scoop the tumor out using a spoon-like tool called a curette. This is a surgery that aims to remove the mass and restore the bone so that the patient can get back to normal function. The lesion is identified within the bone and scooped, or curetted, out. The cavity is then shaved down with a Midas Rex Drill, which is similar to a dental drill. This drill removes more tumor cells.
It is a specialized technique that only a handful of surgeons in the country know how to perform. Once the tumor is removed, liquid nitrogen may be poured into the bone cavity to freeze the area to sub zero temperatures in order to kill microscopic tumor cells. This reduces the chances of the tumor coming back to less than 5%. Warm fluid is also used to prevent normal tissues from freezing.
The empty bone cavity is usually filled with bone graft or bone cement. Bone can be donated (allograft) or taken from the patient themselves (autograft). Fixation devices, such as a plate and screws, may be used in specific situations to prevent postoperative fracture.
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Myself and my amazing team are dedicated to saving your life and your limb. Losing a limb because of a tumor can be a terrifying experience. But, it does not have to be the only option. I’ve spent 20+ years as a Board-Certified Orthopedic Surgeon and Orthopedic Oncologist.
I’ve devoted my career to helping children and adults afflicted with bone and soft tissue masses by performing complex limb saving surgeries. Most patients can have their limb saved, which may require innovative techniques.
Patients afflicted with musculoskeletal tumors have complex conditions that are best taken care of at large hospitals. I am the Chairman of Orthopedics and Chief of Orthopedic Oncology at Morristown Medical Center. My philosophy is a multidisciplinary team approach, working together to tailor treatment to individual patients. Education and research are essential to my practice, providing the best setting for extraordinary patient care. Because of this, we have some of the top results in the country.