• Daina Kashiwazaki, Kazutoshi Hida, Shunsuke Yano, Toshitaka Seki, and Yoshinobu Iwasaki.
• Department of Neurosurgery, Hokkaido University, Graduate School of Medicine, Sapporo, Japan. gktqx702@ybb.ne.jp
• Neurosurgery. 2007 Dec 1; 61 (6): E1336-7; discussion E1337.

ObjectiveHemangiopericytomas, vascular tumors arising in soft tissue, are relatively rare in the central nervous system; they comprise less than 1% of all hemangiopericytomas. Central nervous system hemangiopericytomas occur primarily in the epidural space of the brain and spinal cord. There are no previous reports of subpial, extramedullary growing central nervous system hemangiopericytomas.Clinical PresentationWe document the first case of a subpial hemangiopericytoma with extramedullary growth in the thoracic spine. The patient was a 31-year-old man who developed progressively worsening left lower limb numbness that was followed by gait disturbance over the course of 4 months.InterventionMagnetic resonance imaging revealed an intradural tumor at the T4-T6 level of the thoracic spine. Because the patient's symptoms progressed, he underwent resection of the tumor, which had arisen in the spinal cord subpially without attachment to the dura mater.ConclusionThe pathological diagnosis was hemangiopericytoma. Differential diagnoses include hemangioblastoma, meningioma, schwannoma, and solitary fibrous tumor, the clinical course and prognosis of which are different from hemangiopericytoma. Our experience indicates that hemangiopericytomas can occur as intradural tumors arising from the subpial portion.

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