Incidental Case of Pelvic Haemangiopericytoma: A Clinical Diagnostic Challenge and Clinicopathological Overview

Haemangiopericytoma is a rare vascular tumour. Given its unusual presentation, location, and the clinical diagnostic challenges it poses, hereby, the authors present a case report of a 38-year-old female sought medical attention in the Outpatient Department (OPD) due to pain in her lower abdomen. A pelvic mass was identified in the right adnexa, pushing the uterus to the left. The patient underwent excision of the pelvic mass, considering leiomyoma as a differential diagnosis. A preoperative large mass, approximately 15×20×15 cm in size, was found between the bladder and uterus, adherent to the broad ligament. Subsequently, mass excision was performed along with total abdominal hysterectomy and bilateral salpingo-oophorectomy. The intraoperative and postoperative periods were uneventful. The histopathological report confirmed the diagnosis of haemangiopericytoma. The patient declined radiotherapy and lost to follow-up; later, she succumbed to distant metastasis to the bone and brain four years after treatment. The tumour of the pericyte cells is called haemangiopericytoma. It is considered one of the rarest types of tumours in the pelvis. Most of these tumours are asymptomatic; if they are symptomatic, it is usually due to the compression of adjacent structures or paraneoplastic effects. Computed Tomography (CT) is relevant in establishing the diagnosis, but histopathological examination is confirmatory. The preferred treatment option comprises surgery; at times, preoperative embolisation is necessary to control bleeding. Some literature has highlighted the role of radiotherapy in adjuvant settings to enhance local control. However, the ideal treatment option remains debatable. Surgery is the preferred course of treatment, occasionally following preoperative embolisation of the mass vascularisation. Surgical resection with clear margins and total removal of the tumour offers survival rates of upto 70 to 80% at five and ten years, respectively. The present case is of interest because of its location, rarity, and size.