Nan Yu-Han, Chiu Cheng-Di, Chen Wei-Liang, Chen Liang-Chi, Chen Chun-Chung, Cho Der-Yang, Guo Jeng-Hung
Department of Neurosurgery, China Medical University Hospital, Taichung 404327, Taiwan.
Graduate Institute of Biomedical Science, China Medical University, Taichung 404328, Taiwan.
World J Clin Cases. 2025 Jun 16;13(17):101593. doi: 10.12998/wjcc.v13.i17.101593.
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.
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.
EA with spinal involvement is extremely rare. Early detection and cord decompression may prevent neurological deterioration and preserve better quality of life.
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。
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。
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。