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Minimally Invasive Treatment of a Painful Osteolytic Lumbar Lesion Secondary to Epithelioid Hemangioendothelioma

机译:微创治疗继发于上皮样血管内皮瘤的疼痛性溶骨性腰椎病变

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摘要

>Study Design Case report. >Objective Multifocal epithelioid hemangioendothelioma (EHE) of the spine is a rare disorder. We describe a novel, multimodal treatment of a painful osteolytic lumbar lesion secondary to EHE. The minimally invasive treatment results in an excellent patient outcome with decreased morbidity compared to traditional techniques. >Methods A previously healthy young adult presented with a painful osteolytic lesion at the L2 vertebrae. Imaging revealed multifocal spinal lesions consistent with a history of EHE. Core needle biopsy confirmed the diagnosis. Preoperative cryoablation of L2 was followed by a staged surgery, which included a partial L2 corpectomy, tumor resection, bone grafting, and vertebral reconstruction using a minimally invasive technique. This treatment was followed by prolonged therapy with interferon and bisphosphonate. >Results At 3.5 years' follow-up, the patient has maintained his vertebral body height, has not required a fusion, and has had no recurrence of disease. >Conclusion Multimodal treatment consisting of tumor cryoablation, partial corpectomy, allograft reconstruction of the vertebrae, and adjuvant interferon and bisphosphonate can result in good outcomes for well-contained EHE tumors of the spine.
机译:>研究设计案例报告。 >客观脊柱多灶性上皮样血管内皮瘤(EHE)是一种罕见的疾病。我们描述了继发于EHE的疼痛性溶骨性腰椎病变的新型,多模式治疗。与传统技术相比,微创治疗可实现出色的患者预后并降低发病率。 >方法以前健康的年轻人在L2椎骨上出现了溶骨性病变。影像学检查显示多灶性脊髓病变符合EHE病史。穿刺活检证实了诊断。术前对L2进行冷冻消融,然后进行分阶段手术,包括部分L2体切除术,肿瘤切除,植骨和使用微创技术进行椎体重建。该治疗之后是干扰素和双膦酸盐的长期治疗。 >结果在3.5年的随访中,患者保持了椎体高度,不需要进行融合,也没有疾病复发。 >结论包括肿瘤冷冻消融,部分体切除术,椎体同种异体移植重建,辅助性干扰素和双膦酸盐治疗的多式联运疗法可为良好的脊柱EHE肿瘤带来良好的治疗效果。

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