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Spine (Phila Pa 1976) ; 29(13): E280-3, 2004 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-15223950

RESUMEN

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.


Asunto(s)
Hemangiosarcoma/cirugía , Neoplasias de la Columna Vertebral/cirugía , Vértebras Torácicas/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Dolor de Espalda/etiología , Tornillos Óseos , Sustitutos de Huesos/uso terapéutico , Compuestos de Calcio , Cerámica , Quimioterapia Adyuvante , Terapia Combinada , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Durapatita , Etopósido/administración & dosificación , Estudios de Seguimiento , Hemangiosarcoma/complicaciones , Hemangiosarcoma/tratamiento farmacológico , Humanos , Hipoestesia/etiología , Ifosfamida/administración & dosificación , Fijadores Internos , Masculino , Persona de Mediana Edad , Osteólisis/etiología , Prótesis e Implantes , Implantación de Prótesis , Inducción de Remisión , Silicatos , Compresión de la Médula Espinal/etiología , Neoplasias de la Columna Vertebral/complicaciones , Neoplasias de la Columna Vertebral/tratamiento farmacológico
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