Abstract
We experienced a patient with malignant hemangiopricytoma in the pelvic cavity who was able to survive for 7 years and 6 months after initiation of the treatment.
A 70-year-old woman was seen at the hospital because of severe pain extending from the left gluteal region to left lower extremity in June 1984. A 9×7cm hard tumor was palpated in the left gluteal region. Computed tomography identified a homogeneous tumor mass protruding into the peritoneal cavity and destruction of the pelvis. Angiography showed a hypervascular tumor with internal illiac artery as dominant artery. With biopsy a diagnosis of malignant hemangiopericytoma was made. Bone scintigraphy revealed a hot spot on the right seventh rib. Since radical excision was apparently impossible from these findings, trans arterial embolization of the left internal illiac artery was performed. Two months later, the size of the mass was reduced by 50%. Then chemotherapy with ADM via the left illiac artery using an implanted reservoir was done. The size of the tumor was reduced by 60% at maximum and intratumoral necrosis was recognized. Radiotherapy using 60Co facilitated the intratumoral calcification. No increase in size of the tumor was noted until she died of symptosis after fracture of the right thigh 7 years and 6 months after the initiation of the treatment. In this case multimodal therapy comprizing of trans-arterial embolization of the dominant artery of malignant hemangiopricytoma, intraarterial chemotherapy, and radiotherapy was very effective.
