Surgical treatment of vascular tumors of spine and spinal cord
Keywords:
vascular tumors, spine, spinal cord, treatmentAbstract
Object: The purpose of this study was to analyze patients diagnosed with symptomatic vascular tumors of spine and spinal cord treated at our department over a 20-year period to better define the course of those tumors, the results of treatment, and frequency.
Methods: Eighty-one cases of symptomatic vascular tumors affecting the spine and spinal cord were retrospectively reviewed. This group included 31 patients with hemangiomas, 16 — hemangioblastomas, 5 — angiosarcomas, 9 — hemangiopericytomas, 5 — angiofibromas, 5 — angiolipomas, 9 — hemangioendotheliomas, 1— neoplastic angioendotheliomatosis. The pathology, neuroimaging findings, methods of treatment, results, similarities and differences between each tumor type at each location, are reviewed.
The cases display a spectrum of different highly vascular pathological findings involving the vertebral body, epidural space, intradural extramedullary space, and intramedullary lesions. The primary therapeutic modality used in our series is a surgery, the second are embolization, radiation, observation.
Conclusions: The vascular tumors are different in their origin, histologic appearances and behavior. The unification of this type of tumor as vascular is relative. For example hemangioma in the present time is considering as vascular malformation not a tumor. On the other hand, under no circumstances we can consider hemangioblastomas, hemangiopericitomas, hemangioendotheliomas, and angiosarcomas as the true group of vascular tumors. This is because of their similar origins, histological proximity and presence of the transitional types. The main differences of these tumors are the origin of their neoplastic component (endothelial or perivascular) and the degree of malignity.
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