Sacral epithelioid angiosarcoma associated with a bleeding diathesis and spinal epidural hematoma

Author:

Sanchez-Mejia Rene O.1,Ojemann Steven G.1,Simko Jeff1,Chaudhary Uzair B.1,Levy Jay1,Lawton Michael T.1

Affiliation:

1. Departments of Neurological Surgery, Hematology and Oncology, and Pathology, University of California, San Francisco, California

Abstract

✓Epithelioid angiosarcoma of bone is a rare, high-grade lesion that is highly vascular and can be associated with a bleeding diathesis. An association has been reported in angiosarcomas in other locations with coagulopathy from tumor-related disseminated intravascular coagulopathy and fibrinolysis. The authors report the case of a rare occurrence of a primary sacral epithelioid angiosarcoma associated with a large epidural hematoma and a severe bleeding diathesis. A 25-year-old woman presented with weakness, fatigue, neck and low-back pain, and progressive left S-1 radiculopathy. Imaging studies revealed a large ventral epidural hematoma extending from the sacral region rostrally to C-2 and a vascular tumor located in the sacrum. The patient underwent a sacral laminectomy, complicated by postoperative bleeding from the wound, and required massive transfusions. Ultimately, multimodal therapy was required to obtain hemostasis, including the use of endovascular embolization, radiation therapy, and an infusion of epsilon-aminocaproic acid with heparin. This case represents the first report of a primary epithelioid angiosarcoma in the sacrum and emphasizes that the coagulopathy seen in angiosarcoma is also a feature of this epithelioid variant.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

General Medicine

Cited by 11 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Primary Tumors of the Sacrum: Imaging Findings;Current Medical Imaging Formerly: Current Medical Imaging Reviews;2022-02

2. Primary vertebral epithelioid angiossarcoma—a rare case report and systematic literature review;European Orthopaedics and Traumatology;2014-09-05

3. Preoperative transarterial Embolisation in bone tumors;World Journal of Radiology;2012

4. Embolization of Bone Tumors;Orthopedics;2011-04-11

5. Vascular causes of radiculopathy: a literature review;The Spine Journal;2011-01

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