Primary epithelioid hemangioendothelioma of the lumbar spine

Abstract Background context Primary epitheliod hemangioendotheliomas of the lumbar spine are extremely rare tumors with an unpredictable clinical course. Purpose To present a case of primary lumbar epithelioid hemangioendothelioma and its treatment protocol. Study design/setting A tertiary Spinal Unit. Patient sample A previously healthy adult with persisting low back pain and neurologic deficit. Methods The diagnosis was confirmed by core needle biopsy. The patient was treated with preoperative embolization followed by staged surgery which included wide tumor resection and spinal fixation, using a cage system and a titanium plate anteriorly and a transpedicular fixation system posteriorly. Results Three years postoperatively the patient remains free of symptoms with no evidence of recurrence. Conclusions The treatment of these unpredictable tumors should be dictated by adherence to general oncologic principles.