Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 2:12:21.
doi: 10.25259/JCIS_20_2022. eCollection 2022.

Preoperative embolization of hypervascular spinal tumors: Two case reports

Nguyen Thai Binh  1 , Tran Quoc Hoa  2 , Le Tuan Linh  1 , Thieu-Thi Tra My  3 , Pham Quynh Anh  1 , Nguyen Minh Duc  4
Affiliations

Preoperative embolization of hypervascular spinal tumors: Two case reports

Nguyen Thai Binh et al. J Clin Imaging Sci. .

Abstract

The performance of preoperative embolization on a spinal tumor can be a useful adjunctive procedure that minimizes blood loss and complications, particularly for both metastatic and non-metastatic hypervascular tumors. We discuss two cases of hypervascular spinal tumors that were successfully treated with preoperative embolization and surgery. The first patient was an 18-year-old man who presented with cervical and shoulder pain for two months without paralysis or weakness. Magnetic resonance imaging revealed a tumor located in the D2 posterior vertebral arch that extended into the spinal canal and compressed the spinal cord. The second patient was a 68-year-old man with back pain that radiated to the legs for ten days. Magnetic resonance imaging revealed a mass in the L4 vertebral body. Both patients received tumor embolization and surgery. After surgery, neither patient experienced any major complications. Histological examination revealed osteoblastoma in the first patient and plasmacytoma in the second patient.

Keywords: Angiography; Hypervascular tumor; Preoperative embolization; Spinal tumor.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
An 18-year-old man suffering from left-sided neck stiffness and shoulder pain underwent spinal magnetic resonance imaging. Magnetic resonance images of the tumor. (A and B) Sagittal T2-weighted and short tau inversion recovery images indicated that the lesion on the left posterior vertebral arch of T2 (white arrows) was hyperintense compared with the bone marrow extending to the T2 vertebral body (yellow arrows). (C) The lesion was hypointense on axial T1-weighted images. (D) The mass compressed the spinal cord (arrow). (E) The mass was markedly enhanced on axial T1-weighted with contrast agent and extended to the paraspinal tissue (arrow).
Figure 2:
Figure 2:
An 18-year-old man suffering from left-sided neck stiffness and shoulder pain underwent computed tomography. Computed tomography scan revealing that the tumor was lytic with a rim of sclerosis and a small area of internal calcification (arrow).
Figure 3:
Figure 3:
An 18-year-old man suffering from left-sided neck stiffness and shoulder pain underwent digital subtraction angiography. (A) Selective angiogram demonstrated a hypervascular tumor with a feeding artery arising from the left thyrocervical trunk (arrow). (B) Postembolization angiogram showed complete devascularization, with no reflux into the radiculomedullary artery (arrow).
Figure 4:
Figure 4:
A 68-year-old man with moderate back pain that radiated to the legs underwent spinal magnetic resonance imaging. The L4 vertebral body was isointense on sagittal T2-weighted (A) (arrow) and sagittal T1-weighted (C) (arrow) images but hyperintense on short tau inversion recovery (B) (arrow) images compared with the bone marrow.
Figure 5:
Figure 5:
A 68-year-old man with moderate back pain that radiated to the legs underwent computed tomography. (A and B) The lesion was well-defined and osteolytic, without sclerotic borders or internal calcification (arrow). (C) A CT-guided biopsy of the lesion was performed.
Figure 6:
Figure 6:
A 68-year-old man with moderate back pain that radiated to the legs underwent digital subtraction angiography. A markedly hypervascular tumor at the L4 vertebral was observed, receiving blood from the bilateral L4 segmental arteries (A and B) (arrow). (C) Post-embolization angiogram demonstrated no residual tumor (arrow).
See this image and copyright information in PMC

References

    1. Mohme M, Mende KC, Pantel T, Viezens L, Westphal M, Eicker SO, et al. Intraoperative blood loss in oncological spine surgery. Neurosurg Focus. 2021;50:E14. doi: 10.3171/2021.2.FOCUS201117. - DOI - PubMed
    1. Gong Y, Wang C, Liu H, Liu X, Jiang L. Only tumors angiographically identified as hypervascular exhibit lower intraoperative blood loss upon selective preoperative embolization of spinal metastases: Systematic review and meta-analysis. Front Oncol. 2021;10:597476. doi: 10.3389/fonc.2020.597476. - DOI - PMC - PubMed
    1. Benati A, Dalle Ore G, Da Pian R, Bricolo A, Maschio A, Perini S. Transfemoral selective embolisation in the treatment of some cranial and vertebro-spinal vascular malformations and tumours. Preliminary results. J Neurosurg Sci. 1974;18:233–8. - PubMed
    1. Ozkan E, Gupta S. Embolization of spinal tumors: Vascular anatomy, indications, and technique. Tech Vasc Interv Radiol. 2011;14(3):129–40. doi: 10.1053/j.tvir.2011.02.005. - DOI - PubMed
    1. Houten JK, Swiggett SJ, Hadid B, Choueka DM, Kinon MD, Buciuc R, et al. Neurologic complications of preoperative embolization of spinal metastasis: A systemic review of the literature identifying distinct mechanisms of Injury. World Neurosurg. 2020;143:374–88. doi: 10.1016/j.wneu.2020.08.006. - DOI - PubMed

LinkOut - more resources