Epithelioid hemangioendothelioma of the spine presenting as cervical myelopathy: case report.
OBJECTIVE
We report the first case in the literature of cervical myelopathy caused by progressive cord compression as a result of epithelioid hemangioendothelioma of the cervical vertebra.


METHODS
A 58-year-old man presented with progressive cervical myelopathy. Imaging revealed a vascular, expansile lesion of contiguous cervical vertebrae causing cord compression. The surgical pathology revealed epithelioid hemangioendothelioma, a rare tumor not previously reported to present in such a fashion.


METHODS
Preoperative embolization and a two-stage anterior and posterior surgical decompression and fusion procedure were performed. The high vascularity of this lesion makes surgery a formidable surgical challenge. Adjuvant radiotherapy was administered to the residual tumor because of its potential for low-grade malignancy.


CONCLUSIONS
The diagnosis relied on accurate histopathological assessment. The general principles of achieving cord decompression and tumor control are important. The literature on epithelioid hemangioendothelioma involving the spine is reviewed, and the tumor biology and the role of adjuvant therapy are discussed.
Brennan
J W
JW
Department of Surgery, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada.
Midha
R
R
Ang
L C
LC
Perez-Ordonez
B
B
D015901:Angiography, Digital Subtraction; D002574:Cervical Vertebrae; D019299:Decompression, Surgical; D004621:Embolization, Therapeutic; D006390:Hemangioendothelioma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013117:Spinal Cord Compression / Q000150:complications / Q000209:etiology* / Q000601:surgery; D013118:Spinal Cord Diseases / Q000209:etiology*; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed