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颈椎上皮样血管肉瘤:一例报告。

Epithelioid angiosarcoma of the cervical spine: A case report.

作者信息

Nan Yu-Han, Chiu Cheng-Di, Chen Wei-Liang, Chen Liang-Chi, Chen Chun-Chung, Cho Der-Yang, Guo Jeng-Hung

机构信息

Department of Neurosurgery, China Medical University Hospital, Taichung 404327, Taiwan.

Graduate Institute of Biomedical Science, China Medical University, Taichung 404328, Taiwan.

出版信息

World J Clin Cases. 2025 Jun 16;13(17):101593. doi: 10.12998/wjcc.v13.i17.101593.

Abstract

BACKGROUND

Epithelioid angiosarcoma (EA) is an aggressive, malignant endothelial-cell tumor of vascular or lymphatic origin. EA often arises from deep soft tissues such as pleura, breast, bone and gastrointestinal tract. It usually affects patients aged 60-70 years and is associated with high recurrence and metastasis rates with surgical resection as the primary treatment of choice. Overall survivals are generally poor, ranging from 6 to 16 months. More than 50% of patients died of disease within 2 to 3 years of diagnosis.

CASE SUMMARY

We present a rare case of EA of the cervical spine causing a C6 pathological fracture complicated by severe kyphosis. The patient received C4-7 posterior laminectomy and C2/3/4/7/T1 transpedicular screw fixation, followed by anterior C5-6 corpectomy with allograft bone fusion and cervical plate fixation. Postoperative radiotherapy was administered without delay. However, the patient died of rapidly progressive acute respiratory distress syndrome 3 weeks after the second surgery.

CONCLUSION

EA with spinal involvement is extremely rare. Early detection and cord decompression may prevent neurological deterioration and preserve better quality of life.

摘要

背景

上皮样血管肉瘤(EA)是一种起源于血管或淋巴管的侵袭性恶性内皮细胞肿瘤。EA常发生于深部软组织,如胸膜、乳腺、骨骼和胃肠道。它通常影响60 - 70岁的患者,以手术切除作为主要治疗选择时,其复发和转移率较高。总体生存率通常较差,为6至16个月。超过50%的患者在诊断后2至3年内死于该病。

病例摘要

我们报告一例罕见的颈椎EA病例,该病例导致C6病理性骨折并伴有严重后凸畸形。患者接受了C4 - 7后路椎板切除术和C2/3/4/7/T1经椎弓根螺钉固定,随后进行了C5 - 6前路椎体次全切除、同种异体骨融合和颈椎前路钢板固定。术后立即给予放疗。然而,患者在第二次手术后3周死于快速进展的急性呼吸窘迫综合征。

结论

累及脊柱的EA极为罕见。早期发现和脊髓减压可预防神经功能恶化并保留较好的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07f5/11866273/0d80566a889b/101593-g001.jpg

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