Primary epithelioid hemangioendothelioma of the lumbar spine

Abstract

Background context: Primary epitheliod hemangioendotheliomas of the lumbar spine are extremely rare tumors with an unpredictable clinical course.

Purpose: To present a case of primary lumbar epithelioid hemangioendothelioma and its treatment protocol.

Study design/setting: A tertiary Spinal Unit.

Patient sample: A previously healthy adult with persisting low back pain and neurologic deficit.

Methods: The diagnosis was confirmed by core needle biopsy. The patient was treated with preoperative embolization followed by staged surgery which included wide tumor resection and spinal fixation, using a cage system and a titanium plate anteriorly and a transpedicular fixation system posteriorly.

Results: Three years postoperatively the patient remains free of symptoms with no evidence of recurrence.

Conclusions: The treatment of these unpredictable tumors should be dictated by adherence to general oncologic principles.