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Primary multiple angiosarcoma of vertebra: A case report.

Wei Huang^1,2, Tao Liu¹, Ruimeng Duan¹

¹Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian, 116001, China.

|December 17, 2020

Summary

This case report details an extremely rare instance of primary multiple angiosarcoma of the vertebra in a patient experiencing severe back and leg pain. Minimally invasive surgery and targeted therapies were employed, offering temporary relief but highlighting the aggressive nature of this spinal tumor.

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Area of Science:

Oncology
Orthopedic Surgery
Medical Imaging

Background:

Angiosarcoma is a rare malignant vascular tumor.
Primary vertebral angiosarcoma is exceptionally rare.
This study presents a unique case of multiple vertebral angiosarcoma.

Observation:

A 54-year-old male presented with an 8-month history of progressive low back pain and left lower extremity radiculopathy.
Magnetic resonance imaging revealed pathological fractures and multiple vertebral lesions.
High-throughput sequencing confirmed primary multiple angiosarcoma of the vertebra.

Findings:

The patient underwent successful minimally invasive pedicle screw fixation with bone cement augmentation.
Postoperative radiotherapy and chemotherapy were administered.

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The patient experienced significant pain relief and spinal stabilization, but ultimately died 18 months later.

Implications:

Primary multiple angiosarcoma of the vertebra should be considered in the differential diagnosis of unexplained back pain and radiculopathy.
Minimally invasive surgical techniques, including pedicle screw fixation and osteoplasty with bone cement, are recommended for vertebral angiosarcoma.
Gene analysis-guided targeted radiotherapy and chemotherapy may improve outcomes for this rare malignancy.