Document Detail


Sacral epithelioid angiosarcoma associated with a bleeding diathesis and spinal epidural hematoma: case report.
MedLine Citation:
PMID:  16572625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Rene O Sanchez-Mejia; Steven G Ojemann; Jeff Simko; Uzair B Chaudhary; Jay Levy; Michael T Lawton
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  4     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-31     Completed Date:  2006-04-13     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-50     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, University of California, San Francisco 94143, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Blood Transfusion
Bone Neoplasms / complications*,  drug therapy,  pathology,  surgery
Combined Modality Therapy
Doxorubicin / administration & dosage
Embolization, Therapeutic
Female
Hemangiosarcoma / complications*,  drug therapy,  pathology,  surgery
Hematoma, Epidural, Spinal
Hemorrhagic Disorders
Hemostasis
Humans
Ifosfamide / administration & dosage
Laminectomy
Magnetic Resonance Imaging
Sacrum / pathology,  surgery
Treatment Outcome
Chemical
Reg. No./Substance:
23214-92-8/Doxorubicin; 3778-73-2/Ifosfamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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