Successful surgical treatment of angiosarcoma of the spine: a case report

Spine (Phila Pa 1976). 2004 Jul 1;29(13):E280-3.

Abstract

Study design: Case report.

Objectives: To report primary angiosarcoma of the T8 vertebra, which was successfully managed with en bloc spondylectomy and postoperative chemotherapy.

Summary of background data: To the best of our knowledge, the present case is the first documented example of successful treatment of angiosarcoma of the spine.

Methods: Angiosarcoma of the eighth thoracic vertebra was diagnosed in a 48-year-old man with impending neurologic deficit. Imaging findings revealed a nonspecific high-grade lesion. A total spondylectomy of T8 by en bloc resection was performed. The defect of the vertebral body was reconstructed with a apatite-wollastonite glass ceramic prosthesis; moreover, the T6-T10 vertebrae were instrumented by the pedicle screw, hook and rod system. The histologic diagnosis of the excised specimen was high-grade angiosarcoma. Postoperative chemotherapy was implemented to prevent local recurrence and distant metastasis.

Results: No sign of local recurrence or metastasis was evident 5 years after surgery.

Conclusion: This case is the first documented example of successful treatment of angiosarcoma of the thoracic spine. Radiologic findings were nonspecific; consequently, correct diagnosis was established by pathologic examination. Immediate, aggressive operative treatment and postoperative adjuvant chemotherapy afforded a satisfactory outcome.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Back Pain / etiology
  • Bone Screws
  • Bone Substitutes / therapeutic use
  • Calcium Compounds
  • Ceramics
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Durapatite
  • Etoposide / administration & dosage
  • Follow-Up Studies
  • Hemangiosarcoma / complications
  • Hemangiosarcoma / drug therapy
  • Hemangiosarcoma / surgery*
  • Humans
  • Hypesthesia / etiology
  • Ifosfamide / administration & dosage
  • Internal Fixators
  • Male
  • Middle Aged
  • Osteolysis / etiology
  • Prostheses and Implants
  • Prosthesis Implantation
  • Remission Induction
  • Silicates
  • Spinal Cord Compression / etiology
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / drug therapy
  • Spinal Neoplasms / surgery*
  • Thoracic Vertebrae / surgery*

Substances

  • Bone Substitutes
  • Calcium Compounds
  • Silicates
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Durapatite
  • calcium silicate
  • Ifosfamide