Sacral Nerve Hemangiopericytoma: A Rare Case and Review of the Literature

Introduction: Hemangiopericytomas usually occur in the soft tissue and skeletal system. They rarely present in the spinal canal as a primary tumor. There are several case reports describing primary spinal hemangiopericytomas of the cervical and thoracic spine; however, there are only 3 reports of sacral hemangioperictyomas (Liu, 2013; McMaster, 1975; Zhao, 2007). We report an extremely rare presentation of a primary spinal hemangiopericytoma arising from the S2 nerve root with local bony destruction of the sacrum. Case Report: A 52 year-old male presented with low back pain and left lower extremity numbness and tingling. MRI showed a 5.2 cm x 5.7 cm sacral mass, and CT showed local bony destruction of the sacrum. He complained of left S2 pain. The patient was taken for resection of the tumor. A gross total resection was achieved from a posterior midline approach. A corridor lateral to the sacral nerves allows resection of the ventral portion of the tumor. A gross total resection was achieved with a small residual adherent to the left S2 nerve root. Pathology confirmed the tumor to be a grade II hemangiopericytoma. Adjuvant radiotherapy was recommended due to the residual.