Primary cystic mediastinal hemangiopericytoma: tracking a single case

The mediastinum is an extremely uncommon site for hemangiopericytoma, a rare tumor arising from the pericytes of Zimmermann in the outer wall of capillaries. Histopathology and immunohistochemistry are two main diagnostic tools which differentiate these from synovial sarcoma and solitary fibrous histiocytoma. Surgery is the mainstay of treatment for this tumor with variable malignant potential, adjuvant therapy does not help much. We report a case of primary mediastinal hemangiopericytoma in a 15-year-old lady which recurred after complete surgical excision and a second surgical operation resulted in recurrence again. The first histopathological report after removal of the tumor, revealed a primary cystic hemangiopericytoma, histopathology of the subsequently resected tumor established malignant hemangiopericytoma. Hemangiopericytomas are potentially malignant tumors with high recurrence rate and are very difficult to cure.