Date Posted: June 11, 2026

Author/s: Paul Timothy R. Jacinto, MD and Maria Donna D. Santiago, MD, MBA

This report details a case of hemangiopericytoma in an 18-year-old male patient who was referred due to an orbital mass in the right eye. The patient presented with symptoms including blurred vision, proptosis (eye bulging), a pale optic disc, and a relative afferent pupillary defect (RAPD). Orbital computed tomography (CT) ordered by a referring ophthalmologist revealed an intraconal mass in the right orbit. The patient underwent an excision biopsy of the orbital mass through a lateral orbitotomy with osteotomy under general anesthesia. Significant hemorrhage was noted intraoperatively.

The mass was excised en bloc and sent for histopathological examination, which revealed a solitary fibrous tumor. Immunohistochemistry revealed hemangiopericytoma with malignant potential. The patient was referred to oncology, then radiotherapy for adjuvant external beam radiotherapy using intensitymodulated radiotherapy (IMRT).

Hemangiopericytoma or Solitary fibrous tumor is a rare mesenchymal tumor. Solitary fibrous tumors are uncommon, accounting for only 1.5% of tumors, and present as unilateral, painless masses that can cause proptosis.

Imaging is crucial for diagnosis and planning. Hemangiopericytoma appears as well-circumscribed lesions on CT and MRI. Histologically, it seems to have a staghorn-branched vascular pattern and stains positively on specific markers like CD34 and STAT 6.

Enbloc excision is the preferred treatment, often preceded by embolization to minimize bleeding. For high-risk cases, adjuvant therapy like radiotherapy may be utilized. Visual impairment affects the quality of life and mental health, noting that conditions like strabismus can lead to increased anxiety and depression. Strabismus surgery can enhance interactions and emotional well-being.

Orbital tumors vary by gender and age. The optimal approach to rare orbital tumors like Hemangiopericytoma is best determined by: detailed history, meticulous, cautious, comprehensive physical examination, and appropriate and thorough radiological evaluation. The justification for surgical intervention must consider the presence of a functional deficit, the risk of further progression, the suspected risk of malignancy, the lesion’s location, and aesthetic considerations. Early detection, proper diagnosis, and management are crucial in preventing further complications.

Keywords:
Superior mesenteric artery syndrome, acute appendicitis