Exceptional Response to Lu-177 FAP 2286 Radioisotope Therapy in CNS Hemangiopericytoma: A Novel Therapeutic Breakthrough

Hemangiopericytoma, now reclassified as solitary fibrous tumour, of the central nervous system (CNS), constitutes an exceedingly rare mesenchymal neoplasm originating from the pericytes of meningeal capillaries. These neoplasms typically exhibit a slow growth pattern, with the level of aggressiveness escalating in correlation with higher grades. Minor subsets of this population experience recurrence, and the optimal therapeutic strategy in such circumstances remains ambiguous. Therefore, there exists a continual opportunity for the introduction of innovative treatment modalities. Fibroblast Activation Protein is significantly overexpressed in these tumours, rendering it a promising target for both diagnostic purposes and radioisotope therapy (RIT). We present an unusual case of hemangiopericytoma of the CNS, classified as WHO Grade 3, which manifested recurrence following subtotal resection and adjuvant radiotherapy. The patient subsequently underwent two sessions of Lutetium-177 FAP 2286 (Lu177 FAP2286) radionuclide therapy and exhibited a remarkable response to the FAP-targeted treatment.