Imaging Characteristics of Hemangiopericytoma: A Case Report.

Hemangiopericytoma (HPC) is an uncommon, dural-based, highly vascular intracranial tumor that may mimic meningioma on imaging. These lesions often present with mass effect symptoms and can demonstrate aggressive behavior, including local invasion and recurrence. In this report, we present the case of a 62-year-old female who experienced occipital headaches and was found to have a dural-based lesion in the posterior fossa on MRI. Imaging revealed features including isointensity to hypointensity on T1-weighted images, heterogeneous signal on T2/fluid-attenuated inversion recovery (FLAIR), absence of diffusion restriction, blooming on susceptibility-weighted imaging (SWI), and heterogeneous contrast enhancement with necrotic areas. Unlike meningioma, the lesion showed more aggressive imaging characteristics, including necrosis and prominent vascularity, features more suggestive of HPC. Neurosurgical evaluation and histopathology were essential for diagnosis and further management. The patient underwent left posterior fossa craniotomy with gross total resection of a well-circumscribed, highly vascular dural-based mass. Histopathology confirmed WHO Grade II HPC. Due to the tumor's aggressive nature, adjuvant fractionated radiotherapy was initiated within six weeks. The patient remained neurologically stable on follow-up and was counseled on the need for long-term surveillance.