Primary epithelioid hemangioendothelioma of the lumbar spine

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. (C) 2008 Elsevier Inc. All rights reserved.