Primary epithelioid hemangioendothelioma of the lumbar spine

Background contextPrimary epitheliod hemangioendotheliomas of the lumbar spine are extremely rare tumors with an unpredictable clinical course.PurposeTo present a case of primary lumbar epithelioid hemangioendothelioma and its treatment protocol.Study design/settingA tertiary Spinal Unit.Patient sampleA previously healthy adult with persisting low back pain and neurologic deficit.MethodsThe 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.ResultsThree years postoperatively the patient remains free of symptoms with no evidence of recurrence.ConclusionsThe treatment of these unpredictable tumors should be dictated by adherence to general oncologic principles.