Villanueva-Castro Eliezer, Ramírez-Aragón Sergio, Del Pino-Camposeco Jorge, Canela-Calderon Obet, Ponce-Gómez Juan Antonio, Arriada-Mendicoa Juan Nicasio
Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Department of Neurosurgery, Hospital Central Militar, Mexico City, MEX.
Cureus. 2024 Apr 18;16(4):e58571. doi: 10.7759/cureus.58571. eCollection 2024 Apr.
We report a 48-year-old male patient with spinal epithelioid hemangioendothelioma in T3 and T4 who began with symptoms of paresthesia in the lower limbs and distal weakness of the right lower limb, back pain, increased limitation in walking, urinary incontinence, and constipation. A safe maximum resection was performed, finding residual disease during the PET/CT scan, so it was decided to treat with radiotherapy, and there was a good response to this treatment. A literature review of epithelioid hemangioendothelioma of the thoracic spine was done which showed a mean age of presentation of 41 years and a male-female ratio of 1:0.53. The main symptom was pain, which was present in 100% of the patients, and wide surgery was performed in 56.8% of the patients, intralesional surgery in 31.8%, and biopsy in 11.4%. A total of 46.6% of patients received radiation therapy, and only 6.6% received chemotherapy. The patients had an average follow-up of 38 months. We recommend that extension studies such as PET/CT scans be performed after surgical resection. This can serve as a follow-up with hemangioendothelioma epithelioma patients about metastatic disease or residual disease that will guide us in giving adjuvant treatments, such as radiotherapy or chemotherapy, for better control of the disease.
我们报告了一名48岁男性患者，其T3和T4椎体患有脊柱上皮样血管内皮瘤，最初表现为下肢感觉异常、右下肢远端无力、背痛、行走受限加重、尿失禁和便秘。进行了安全的最大程度切除，在PET/CT扫描时发现有残留病灶，因此决定进行放射治疗，且该治疗反应良好。对胸椎上皮样血管内皮瘤进行了文献综述，结果显示其平均发病年龄为41岁，男女比例为1:0.53。主要症状为疼痛，100%的患者均有此症状，56.8%的患者进行了广泛手术，31.8%进行了病灶内手术，11.4%进行了活检。共有46.6%的患者接受了放射治疗，仅6.6%接受了化疗。患者平均随访38个月。我们建议在手术切除后进行PET/CT扫描等扩展检查。这可作为对血管内皮瘤患者转移疾病或残留疾病的随访，将指导我们给予辅助治疗，如放疗或化疗，以更好地控制疾病。
