gms | German Medical Science

A myopericytoma is a rare, mostly benign soft-tissue tumor that originates from perivascular myoid cells. Whereas this tumor was seen as a kind of haemangiopericytoma in the past, the myopericytoma became an entity in the last few years.

A 69-year old man presented with nasal obstruction for weeks and no other symptoms. CT-scan of paranasal sinuses as well as endoscopy of the nose and nasopharynx showed a polypous tumor in the right nasopharynx. After excision of the nasopharyngeal tumor, histology showed an epitheloid haemangioma. Three years later the patient complained again of nasal obstruction. CT-scan showed a 2x3x2 cm soft-tissue tumor of the nasopharynx. The tumor was excised in GA showing a haemangioma-like mass originating from the nasopharyngeal roof. This time histology showed a myopericytoma of uncertain dignity, not completely excised. Review of the tissue excised 3 years earlier led to it being considered a myopericytoma as well.

Staging included head and neck MRI, chest-CT and neck sonography but showed neither signs of metastases nor residual tumor. Because of the histology with increased proliferating activity and therefore uncertain dignity the tumor had to be considered to be a malignant proliferation. Resurgery was performed to achieve total excision. However it was uncertain if this was achieved due to multiple tissue pieces. The patient underwent radiotherapy and now have regular follow up appointments.

Myopericytomas of uncertain dignity should be considered malignant and require total excision and postsurgery radiotherapy. Regular follow-up with yearly MRI scans of the head and neck help to detect recurrences which need immediate biopsy and an appropriate treatment regime.