International Publisher of Science, Technology and Medicine

Journal of Spine & Neurosurgery

Case Report

Successful Multimodality Treatment and Long- Term Follow-Up of a Primary Spinal Epithelioid Hemangioendothelioma

Tsitsopoulos PP1*, Anestis DM1, Nikolaidou C2, Venizelos I2, Tsonidis CA1 and Tsitsopoulos PD1
1Department of Neurosurgery, Aristotle University Medical School, Thessaloniki, Greece
2Department of Pathology, Hippokratio General Hospital, Thessaloniki, Greece
Corresponding author : Tsitsopoulos P
Department of Neurosurgery, Aristotle University Medical School and Department of Pathology, Hippokratio General Hospital, Thessaloniki, Greece
E-mail: par_tsits@yahoo.gr
Received: December 14, 2014 Accepted: December 01, 2014 Published: January 03, 2015
Citation: Tsitsopoulos PP, Anestis DM, Nikolaidou C, Venizelos I, Tsonidis CA, et al. (2015) Successful Multimodality Treatment and Long-Term Follow-Up of a Primary Spinal Epithelioid Hemangioendothelioma. J Spine Neurosurg 4:2 doi:10.4172/2325-9701.1000183

Abstract

Successful Multimodality Treatment and Long- Term Follow-Up of a Primary Spinal Epithelioid Hemangioendothelioma

Introduction: Epithelioid hemangioendothelioma (EHE) is an unusual vascular tumor which is rarely found in the spine. It has metastatic potential and unpredictable behavior. The choice of treatment remains controversial with the role of radiotherapy and chemotherapy still not clearly established.

Case presentation: The case of a 63-year-old female patient with a spinal EHE that presented with gradually deteriorating paraparesis and sensory deficits is reported. Radiologic work-up revealed the presence of a mid-thoracic vertebral mass which extended epidurally and into the thoracic cavity. She underwent laminectomy and removal of the epidural mass. Postoperatively, she was further treated with intravascular embolization and stereotactic radiosurgery. These resulted in significant reduction of the tumor. Histopathologic analysis confirmed the diagnosis of EHE. Seven years later, she remained symptom-free with no evidence of tumor recurrence on Magnetic Resonance Imaging.

Conclusion: Selective surgical excision combined with embolization and stereotactic radiosurgery may be effective in treating spinal EHEs obviating the need for an extensive surgery. To our knowledge, this is the first such case reported in the literature.

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