Although unusual, hemangiopericytoma (HPC) can be considered benign or malignant depending on histologic features. In some cases, malignant HPC can behave as high-grade sarcomas. When HPC is deemed malignant, radical surgical excision is the treatment of choice. Adjuvant chemotherapy and radiation therapy offer limited success in patients with this malignancy. This article details a case study of a man with metastatic malignant HPC that spanned 25 months and three major cancer centers. Throughout the case study, chemotherapy, radiation therapy, and an experimental agent were employed to attempt to achieve control of the aggressive disease. Often, patients with HPC need a multidisciplinary approach to their care that requires involvement of nutritional and social services, behavioral medicine, and home or hospice care as appropriate. A better general understanding of this disease process is needed to meet the needs of patients with malignant HPC.