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Aggressive Vertebral Hemangioma


Authors: R. Kostyšyn 1;  Z. Pleskačová 2;  V. Málek 1
Authors‘ workplace: LF UK a FN Hradec Králové Neurochirurgická klinika 1;  LF UK a FN Hradec Králové Klinika onkologie a radioterapie 2
Published in: Cesk Slov Neurol N 2015; 78/111(2): 148-157
Category: Review Article

Overview

Hemangioma is the most common primary benign hamartoma type spine tumor. Malignant degeneration has never been reported. In the majority of cases, this is an asymp­tomatic solitary lesion of the thoracic spine found incidentally during a radiographic examination. Only 1% of cases manifests clinically and this benign lesion is considered aggressive because of the expansive nature of the tumor and because it may cause pathological fracture of the vertebrae. Clinical symp­toms then include dorsalgia and either root or spinal neurological symp­toms. Radiological dia­gnosis is relatively easy because vertebral hemangioma is associated with quite typical graphic signs; graphic criteria to confirm the dia­gnosis of aggressive vertebral hemangioma have been clearly defined. The range of treatment options is very wide, from conservative treatment through frequently used vertebroplasty to radical surgical treatment. Embolization procedures, alcohol sclerotherapy and local radiotherapy are often used as complementary procedures. Aggressive vertebral hemangioma is a relatively rare dia­gnosis, so far there are no large cohorts or clinical studies from which it would be possible to determine an optimal therapeutic approach.

Key words:
hemangioma – vertebroplasty – angiogenesis inhibitors – angiomatosis – propranolol

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for bio­medical papers.


Sources

1. Greenberg MS. Handbook of Neurosurgery. Thieme 2010: 738– 739.

2. Adam Z, Krejčí M, Vorlíček J et al. Přehled maligních hematologických nemocí. 2. vyd. Praha: Grada 2008: 360– 361.

3. Adam Z, Matýšková M, Tomíška M, Řehák Z, Koukalová R,Křikavová L et al. Šestileté sledování pa­cienta s mnohočetnou angiomatózou postihující skelet, břišní i hrudní dutinu a stěnu trávicí trubice. Klin Onkol 2012; 25(1): 47– 62.

4. Ryška P, Hrubešová J, Málek V, Pavlíková V, Kračmarová R,Řehák S. Perkutanní vertebroplastika a kyfoplastika. Hradec Králové: Olga Čermáková 2010: 65– 74.

5. Laredo JD, Assouline E, Gaston A, Gelbert F, Merland JJ.Radiologic evaluation of an isolated vertebral hemangioma. Neurochirurgie 1989; 35(5): 305– 308.

6. Pastushyn A, Slin‘ko E, Mirzoyeva G. Vertebral hemangio­mas: dia­gnosis, management, natural history and clinico-pathological correlates in 86 patients. Surg Neurol 1998; 50: 535– 547.

7. Castel E, Lazennec JY, Chiras J, Enkaoua E, Saillant G. Acute spinal cord compression due to intraspinal bleeding from a vertebral hemangioma: two case‑ reports. Eur Spine J 1999; 8(3): 244– 248.

8. Acosta FL jr, Sanai N, Cloyd J, Deviren V, Chou D, Ames CP.Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature. J Spinal Disord Tech 2011; 24(4): 268– 275. doi: 10.1097/ BSD.0b013e3181efe0a4.

9. Fernandez‑ Torron R, Palma JA, Riverol M, Irimia P, Martinez‑ Vila E. Brown‑ sequard syndrome after endovascular embolization of vertebral hemangioma. Spinal Cord 2012; 50(8): 636– 637. doi: 10.1038/ sc.2012.3.

10. Cianfoni A, Massari F, Dani G, Lena JR, Rumboldt Z, Vandergrift WA et al. Percutaneous ethanol embolization and cement augmentation of aggressive vertebral hemangiomas at two adjacent vertebral levels. J Neuroradiol 2014; 41(4): 269– 274. doi: 10.1016/ j.neurad.2012.10.003.

11. Heyd R, Strassmann G, Filipowicz I, Borovsky K, Martin T, Zamboglou N. Radiotherapy in vertebral hemangioma. Rontgenpraxis 2001; 53(5): 208– 209.

12. Giavazzi R, Garofalo A, Ferri C, Lucchini V, Bone EA, Chiari S et al. Batimastat, a synthetic inhibitor of matrix metalloproteinases, potentiates the antitumor activity of cisplatin in ovarian carcinoma xenografts. Clin Cancer Res 1998; 4(4): 985– 992.

13. O‘Reilly MS, Brem H, Folkman J. Treatment of murine hemangioendotheliomas with the angiogenesis inhibitor AGM‑ 1470. J Pediatr Surg 1995; 30(2): 325– 329.

14. Pan D, Sanyal N, Schmieder AH, Senpan A, Kim B, Yang X et al. Antiangiogenic nanotherapy with lipase‑ labile Sn‑ 2 fumagillin prodrug. Nanomedicine (Lond) 2012; 7(10): 1507– 1519. doi: 10.2217/ nnm.12.27.

15. Vijay K, Shetty AP, Rajasekaran S. Symp­tomatic vertebral hemangioma in pregnancy treated antepartum. A case report with review of literature. Eur Spine J 2008; 17 (Suppl 2): 299– 303. doi: 10.1007/ s00586‑ 008‑ 0592‑ 2.

16. Shinozaki M, Morita A, Kamijo K, Seichi A, Saito N, Kirino T. Symp­tomatic T2 vertebral hemangioma in a pregnant woman treated by one stage combination surgery; posterior stabilization and anterior subtotal tumor resection. Case report. Neurol Med Chir (Tokyo) 2010; 50(8): 674– 677.

17. Jha B, Choudhary AK. Unusual cause of back pain in an adolescent patient: a case report and natural history of aggressive vertebral hemangioma in children. Pain Physician 2008; 11(5): 687– 692.

18. Uzunaslan D, Saygin C, Gungor S, Hasiloglu Z, Ozdemir N, Celkan T. Novel use of propranolol for management of pain in children with vertebral hemangioma: report of two cases. Childs Nerv Syst 2013; 29(5): 855– 860. doi: 10.1007/ s00381‑ 012‑ 2012‑ 5.

19. Mihál V, Novák Z, Hůlková E, Michálková K. Kdy je indikována léčba infantilních hemangiomů propranololem? Pediatrie pro praxi 2011; 12(2): 108– 110.

20. Karaeminogullari O, Tuncay C, Demirors H, Akin K, Sahin O, Ozyurek A et al. Multilevel vertebral hemangiomas: two episodes of spinal cord compression at separate levels 10 years apart. Eur Spine J 2005; 14(7): 706– 710.

21. Schrock W, Wetzel R, Tanner S, Khan M. Aggressive hemangioma of the thoracic spine. Radiology Case 2011; 5(10): 7– 13. doi: 10.3941/ jrcr.v5i10.828.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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2015 Issue 2

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