Successful surgical treatment of angiosarcoma of the spine: a case report.
METHODS
Case report.


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


BACKGROUND
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.


CONCLUSIONS
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.
Kawashima
Hiroyuki
H
Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan. inskawa@med.niigata-u.ac.jp
Ishikawa
Seiichi
S
Fukase
Masayuki
M
Ogose
Akira
A
Hotta
Tetsuo
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D001863:Bone Screws; D018786:Bone Substitutes / Q000627:therapeutic use; D017610:Calcium Compounds; D002516:Ceramics; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D017886:Durapatite; D005047:Etoposide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006394:Hemangiosarcoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007069:Ifosfamide / Q000008:administration & dosage; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012074:Remission Induction; D017640:Silicates; D013117:Spinal Cord Compression / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*
D018786:Bone Substitutes; D017610:Calcium Compounds; D017640:Silicates; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D017886:Durapatite; C031293:calcium silicate; D007069:Ifosfamide