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Bialek S, Villeneuve LM, Bauer A, Phan M, Johnston A, Spence C, Graffeo CS. Neurosurgical Management of Spinal Epithelioid Hemangioendothelioma: Systematic Review and Illustrative Case Presentation. World Neurosurg 2024; 188:99-110. [PMID: 38734166 DOI: 10.1016/j.wneu.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor predominantly arising in soft tissue. We report a rare case of thoracic spinal EHE with pulmonary metastasis. METHODS Case report and systematic review of spinal EHE. RESULTS A 36-year-old man presented with bilateral lower extremity weakness, progressive paresthesia, and urinary incontinence. He underwent open surgical resection of the tumor and decompression of the spinal cord, with subsequent improvement in neurologic function. Systematic review identified 84 cases of spinal EHE, 73 of which were primary, and 14 of which developed extra-spinal metastases. CONCLUSION EHE is an exceedingly rare tumor that may present with a wide swath of clinical symptoms. At present, no guidelines or formal treatment recommendations have been established. Surgical debulking has demonstrated efficacy as a front-line treatment, particularly in the setting of compressive neurologic dysfunction; data regarding adjuvant chemoradiation are less consistently reported, mandating further study.
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Affiliation(s)
- Shannan Bialek
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Lance M Villeneuve
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Andrew Bauer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Minh Phan
- Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Andrea Johnston
- Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Caple Spence
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Christopher S Graffeo
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
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Tomasian A, Jennings JW. Benign Bone Tumors Beyond Osteoid Osteoma: Percutaneous Minimally Invasive Image-Guided Interventions. Cardiovasc Intervent Radiol 2023; 46:1483-1494. [PMID: 37532944 DOI: 10.1007/s00270-023-03515-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/09/2023] [Indexed: 08/04/2023]
Abstract
Painful benign bone tumors often adversely influence quality of life primarily due to skeletal-related events such as unremittable pain, pathologic fracture, neurologic deficit, as well as skeletal growth disturbance. Substantial advances in percutaneous minimally invasive interventions for treatment of painful benign bone tumors beyond osteoid osteoma have been established as safe, efficacious, and durable treatments to achieve definitive cure. This article details the available armamentarium and most recent advances in minimally invasive percutaneous interventions and the role of radiologists for the management of patients with benign bone tumors beyond osteoid osteoma.
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Affiliation(s)
- Anderanik Tomasian
- Department of Radiological Sciences, University of California, Irvine Medical Center, 101 The City Dr. S, Orange, CA, 92868, USA.
| | - Jack W Jennings
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 South Kingshighway Blvd, St. Louis, MO, 63110, USA
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Tomasian A, Cazzato RL, Sharma K, Gangi A, Jennings JW. Benign Bone Tumors: State of the Art in Minimally Invasive Percutaneous Interventions. Radiographics 2023; 43:e220041. [PMID: 36563097 DOI: 10.1148/rg.220041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Painful benign bone tumors most commonly affect pediatric patients and young adults. They may be associated with skeletal-related events such as intractable pain, pathologic fracture, neurologic deficit as a consequence of nerve or spinal cord compression, as well as growth disturbance. Consequently, they often result in diminished activity and adversely affect quality of life. There have been substantial recent advances in percutaneous minimally invasive image-guided interventions for treatment of painful benign bone tumors including thermal ablation (radiofrequency ablation, cryoablation, microwave ablation, laser photocoagulation, and high-intensity focused US ablation), chemical (alcohol) ablation, cementoplasty, and intralesional injections. The safety, efficacy, and durability of such interventions have been established in the recent literature and as such, the role of musculoskeletal interventional radiologists in the care of patients with benign bone lesions has substantially expanded. The treatment goal of minimally invasive musculoskeletal interventions in patients with benign bone tumors is to achieve definitive cure. The authors detail the most recent advances and available armamentarium in minimally invasive image-guided percutaneous interventions with curative intent for the management of benign bone tumors. © RSNA, 2022.
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Affiliation(s)
- Anderanik Tomasian
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Roberto Luigi Cazzato
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Karun Sharma
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Afshin Gangi
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Jack W Jennings
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
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Witte S, Weidema M, Kaal S, Versleijen-Jonkers Y, Flucke U, van der Graaf W, Desar I. The heterogeneity of Epithelioid Hemangioendothelioma (EHE): A case series and review of the literature with emphasis on treatment options. Semin Oncol 2021; 48:111-118. [PMID: 34176654 DOI: 10.1053/j.seminoncol.2021.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 12/28/2022]
Abstract
Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma with a very heterogeneous presentation and prognosis. We here present five cases of EHE emphasizing diversity in presentation, treatment, and prognosis. Furthermore, we present a review of the literature on EHE treatment options.
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Affiliation(s)
- Stijn Witte
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Marije Weidema
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Suzanne Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Uta Flucke
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Winette van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ingrid Desar
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands.
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Chen PK, Lin QT, Feng YZ, Weng ZP, Cai XR. Epithelioid hemangioendothelioma of spine: A case report with review of literatures. Radiol Case Rep 2020; 15:2687-2692. [PMID: 33117468 PMCID: PMC7581828 DOI: 10.1016/j.radcr.2020.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 01/07/2023] Open
Abstract
Primary epithelioid hemangioendothelioma of the spine is the extremely rare malignant vascular neoplasm with an unpredictable outcome. A case of epithelioid hemangioendothelioma with multiple lytic lesions of thoracolumbar spine and other bones in a 29-year-old male patient is reported. A review of the published data regarding this rare neoplasm is also presented. The features of epithelioid hemangioendothelioma include the occurrence in the young male patient, multiple osteolytic lesions with thin sclerotic rim and hypermetabolic activities. However, its imaging features are not specific. Positron emission tomography/computed tomography is essential for identification of the lesions and subsequent follow-up for treatment.
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Affiliation(s)
- Ping-Kang Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - Qi-Ting Lin
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - You-Zhen Feng
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - Ze-Ping Weng
- Department of Pathology, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Xiang-Ran Cai
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
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Tang L, Chen G, Wang Q, John J, Lu C. Bisphosphonates as a therapeutic choice for multifocal epithelioid hemangioma of bone: A case report. Medicine (Baltimore) 2019; 98:e18161. [PMID: 31770261 PMCID: PMC6890370 DOI: 10.1097/md.0000000000018161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Epithelioid hemangioma (EH) of bone is an intermediate vascular tumor that can be locally aggressive. The optimum management of multifocal EH of bone is not well delineated. We described our experience treating one patient with multifocal EH of bone in an effort to document the effect of bisphosphonates in bone EH. PATIENT CONCERNS In this report, a 53-year old male patient presented with back pain which was initially been diagnosed of multiple bone metastatic carcinoma by 18F-FDG PET/CT scan and bone scintigraphy. DIAGNOSIS CT-guided bone biopsy of ilium indicated that puncture tissue had irregular hyperplasia of thick and thin-walled blood vessels, immunohistochemistry revealed positive staining for CD31 and CD34, negative for CAMTA-1, PCK and EMA, which confirmed the diagnosis of multiple EH. INTERVENTIONS The patient was treated with 4 times of intravenous Zometa (zoledronate, 4 mg each time) with average three-month interval. Bone metabolic markers including serum bone specific alkaline phosphatase (BALP) and type I collagen cross-linked C-terminal telopeptide (CTX) levels were closely monitored before and after use of bisphosphonates each time. OUTCOME BALP and CTX were significantly lowered following intravenous Zometa and the back pain improved with integrated therapy including bone graft fusion internal fixation surgery and vertebroplasty. CONCLUSIONS EH of multiple bones responded favorably to intravenous Zometa with improvement of bone metabolic markers. After 1 year on follow-up, the patient was doing well with no significant pain. We suggest that bisphosphonates should be considered in the treatment of multifocal osteolytic EH of bone.
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Affiliation(s)
- Lizhi Tang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University
| | - Guangwen Chen
- Department of Radiology, Sichuan Provincial People's Hospital, Chengdu, China
| | - Qin Wang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University
| | - Jobin John
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University
| | - Chunyan Lu
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University
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Challenges in Management of Epithelioid Hemangioendothelioma of the Spine: The Report of a Rare Cause of Cauda Equina Syndrome. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.85206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Witte HM, Riecke A, Mayer T, Hackenbroch C, Steinestel K, Gebauer N, Puckhaber D, Mathieu R, Mauer UM, Schulz C. Multifocal and hormone-dependent epithelioid hemangioendothelioma with osteolysis of the second cervical vertebral body: report of an unprecedented surgical approach by using autologous bone graft. Br J Neurosurg 2019:1-9. [PMID: 31583911 DOI: 10.1080/02688697.2019.1668542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report the case of a 28-year-old female patient who complained of extreme neck pain when giving birth to a child. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an osteolytic lesion at the second cervical vertebral body (C2). In this presentation, we highlight a transoral surgical approach in order to prevent instability of this osteolytic lesion. To the best of our knowledge, this is the first time that such a route of access has been described for this tumor entity. A histopathologic examination led to the diagnosis of epithelioid hemangioendothelioma. During a follow-up period of 33 months, the patient had no complaints.
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Affiliation(s)
- Hanno M Witte
- Department of Hematology and Oncology, German Armed Forces Hospital of Ulm , Ulm , Germany.,Department of Hematology and Oncology, UKSH Campus Lübeck , Lübeck , Germany
| | - Armin Riecke
- Department of Hematology and Oncology, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Thomas Mayer
- Department of Hematology and Oncology, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Carsten Hackenbroch
- Department of Radiology, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Konrad Steinestel
- Institute of Pathology and Molecular Pathology, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Niklas Gebauer
- Department of Hematology and Oncology, UKSH Campus Lübeck , Lübeck , Germany
| | - Dirk Puckhaber
- Department of Neurosurgery, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - René Mathieu
- Department of Neurosurgery, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Uwe Max Mauer
- Department of Neurosurgery, German Armed Forces Hospital of Ulm , Ulm , Germany
| | - Chris Schulz
- Department of Neurosurgery, German Armed Forces Hospital of Ulm , Ulm , Germany
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Slavnic D, Carr D, Tong D, Houseman C. Reconstruction of a Thoracic Spine Epithelioid Hemangioendothelioma with Antibiotic Impregnated Poly-methyl Methacrylate: A Case Report. Cureus 2019; 11:e5713. [PMID: 31720181 PMCID: PMC6823094 DOI: 10.7759/cureus.5713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
A 58-year-old female presented to the hospital with respiratory distress several days after a right hallux amputation. A new lytic lesion within the fourth thoracic (T4) vertebral body and mediastinal lymphadenopathy was noted on chest computed tomography scan. A bone biopsy was performed, revealing bone and collagenous fragments only. Two months later, new imaging revealed approximately 60% lytic destruction of the T4 vertebral body with new right pedicle involvement. Surgical treatment was offered. Intraoperative frozen pathology indicated a hemangioma. An intralesional debulking and stabilization was performed. The right T4 nerve was sacrificed to gain access to the entire vertebral body. Curettage was then used to push the tumor away from the spinal canal into the vertebral body. The spine was reconstructed with 5-10mm beads of Simplex P bone cement (Stryker®, Kalamazoo, MI) which contained 40 grams of poly-methyl methacrylate and 1 gram of tobramycin. Five months after resection, the patient presented with computed tomography and magnetic resonance imaging findings of recurrent disease at T4 and spread to the adjacent T5 vertebral body with lytic changes. At 18 months following her second debulking surgery and radiation treatment, the patient was doing well with no pain or numbness. Long-term imaging compared to the patient’s preoperative imaging displayed improvement in spinal debulking with minimal residual enhancement of tumor despite significant artifact.
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Affiliation(s)
- Dejan Slavnic
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Daniel Carr
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Doris Tong
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Clifford Houseman
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
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Abstract
BACKGROUND Open approaches to the thoracolumbar spine for en bloc vertebral body tumor resection are associated with significant surgical morbidity. Less invasive surgical techniques may reduce complications. OBJECTIVE To present our experience with a staged posterior midline and mini-open anterolateral extracoelomic approach to en bloc corpectomy for vertebral body tumor resection in cadaver specimens and patients. MATERIALS AND METHODS The feasibility and safety of the staged posterior midline and mini-open anterolateral extracoelomic approach were evaluated in 3 cadaveric specimens. The procedure was performed at 3 levels (L1-L3) in each cadaver specimen (9 levels) and then in 1 clinical case. The cadaveric neurovascular structures were evaluated for tissue injury, whereas the operative experience, patient complications, and early surgical and clinical outcomes were reviewed. RESULTS The approach allowed for en bloc corpectomy without any injury to the cadaveric neurovascular structures. The procedure was reproducible in the clinical setting, which showed favorable clinical and radiographic patient outcomes. CONCLUSIONS Early clinical experience suggests the staged posterior midline and mini-open anterolateral extracoelomic approach is feasible and safe for en bloc tumor resection compared with open techniques with related morbidity. Long-term studies are needed to understand the strengths and limitations of this technique.
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Abstract
Understanding and management of vascular anomalies has always been intriguing. These disorders exhibit an expected pattern of clinical presentation and progression, and characteristic imaging findings. Significant progress in understanding and treating patients with vascular anomalies has been made in the past quarter century. Newer multidisciplinary domains for treating these disorders with medical drugs and less invasive image-guided or surgical procedures are constantly evolving. Vascular anomalies can exhibit aggressive tumor-like behavior resulting in recurrence or persistent symptoms after treatment. Thermal ablation has been widely used in tumor treatment. This has generated interest on using thermal ablation for treating vascular anomalies. Percutaneous image-guided cryoablation is increasingly used for this purpose as compared with other ablation technologies. Availability of small caliber cryoprobes and the ability to monitor the freeze zone in real time have made this an attractive option to interventional radiologists. These experiences are relatively new and limited. It is helpful to understand the emerging role of this technology in the treatment of vascular anomalies.
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Affiliation(s)
- Raja Shaikh
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
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Albakr A, Schell M, Drew B, Cenic A. Epithelioid hemangioendothelioma of the spine: case report and review of the literature. JOURNAL OF SPINE SURGERY 2017; 3:250-259. [PMID: 28744509 DOI: 10.21037/jss.2017.05.05] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Epithelioid hemangioendothelioma (EHE) has been described as a rare vascular bone lesion with histological features between hemangioma and high-grade angiosarcoma. Spinal EHE is a quite rare disease with few case reports and series reported in the literature. The tumor cells are positive for vimentin, CD31and CD34, factor VIII related antigen, ERG, and FLI1. Radiological features are not specific; it may appear as an osteolytic lesion. It can present as a multifocal disease in 40% of cases. No clear correlation with age and sex; however, it is slightly more common in males. Focal neck or back pain is the most common presenting symptom. The natural history of spinal EHE is unpredictable, and currently, there is no standard of care for treatment. Treatment options include preoperative embolization, and surgical resection followed by radiotherapy and/or chemotherapy. A 34-year-old previously healthy male presented with mid-thoracic back pain. Magnetic resonance imaging (MRI) of the spine revealed a decrease in vertebral body height at T5 with an enhancing mass. He underwent T5 balloon kyphoplasty and needle vertebral body biopsy. Results of the biopsy samples were non-diagnostic. Approximately 3 months after surgery, the patient presented with unsteady gait. A subsequent MRI revealed progression of the T5 compression fracture with cord compression. The patient subsequently underwent T4-T6 bilateral posterior decompression for epidural tumor and T3-T7 posterior instrumentation with pedicle screws. Pathology of the lesion revealed EHE. The patient was started on local radiation therapy (RT). On follow-up, 3 months after the second surgery, the thoracic spinal pain had improved dramatically. Our review highlights the diagnosis, clinical presentation, and treatment of spinal EHE. Complete resection is associated with good outcome. Radiotherapy has been used in partially resected lesions. However, the role of radiotherapy as primary treatment is not yet defined. Further studies should develop a treatment algorithm for this rare tumour.
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Affiliation(s)
- Abdulrahman Albakr
- Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Tomasian A, Wallace AN, Jennings JW. Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment. AJNR Am J Neuroradiol 2017; 38:852-861. [PMID: 28183835 DOI: 10.3174/ajnr.a5084] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Minimally invasive percutaneous imaging-guided techniques have been shown to be safe and effective for the treatment of benign tumors of the spine. Techniques available include a variety of tumor ablation technologies, including radiofrequency ablation, cryoablation, microwave ablation, alcohol ablation, and laser photocoagulation. Vertebral augmentation may be performed after ablation as part of the same procedure for fracture stabilization or prevention. Typically, the treatment goal in benign spine lesions is definitive cure. Painful benign spine lesions commonly encountered in daily practice include osteoid osteoma, osteoblastoma, vertebral hemangioma, aneurysmal bone cyst, Paget disease, and subacute/chronic Schmorl node. This review discusses the most recent advancement and use of minimally invasive percutaneous therapeutic options for the management of benign spine lesions.
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Affiliation(s)
- A Tomasian
- From the Department of Radiology (A.T.), University of Southern California, Los Angeles, California
| | - A N Wallace
- Mallinckrodt Institute of Radiology (A.N.W., J.W.J.), St Louis, Missouri
| | - J W Jennings
- Mallinckrodt Institute of Radiology (A.N.W., J.W.J.), St Louis, Missouri
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