Epithelioid hemangioma is recognized by the World Health Organization as a distinct benign neoplasm; however, it is characterized by locally aggressive and rarely metastasizing behavior. Epithelioid vascular tumors are rare bony vascular lesions with varying degrees of malignant potential that remain controversial because of their rarity, unusual morphological features, and unpredictable biological behavior. The application of new molecular tools, such as massive parallel sequencing technologies, have provided new diagnostic markers and an opportunity to further refine the classification of bone vascular neoplasms. Very few cases of EH of the spine have been reported in the literature; therefore, it is difficult to make evidence-based therapeutic decisions for these patients. We report herein our experience with eleven patients suffering from EH of the spine. The study population included three males and eight females treated in our center from 2016 to the present; the average age was 44.8 years (range 14–75 years). The surgical, clinical, and radiographic data were retrospectively analyzed. The mean follow-up was 34.8 months. All patients presented lytic vertebral body lesions, six of them with pathological fracture. The majority of patients (80%) presented myelo-radicular compression. All patients were surgically treated, and preoperative embolization was performed in all cases. In light of the literature review and the clinical experience of our center, we can consider EH a locally aggressive tumor that requires surgical treatment in case of symptoms. Here, we propose a treatment algorithm that could be useful in the management of patients with this rare disease.
上皮样血管瘤被世界卫生组织认定为一种独特的良性肿瘤，但其具有局部侵袭性且罕见转移的特征。上皮样血管肿瘤是罕见的骨血管病变，因其恶性潜能存在争议，这主要源于其罕见性、不典型的形态学特征及不可预测的生物学行为。新型分子工具（如大规模平行测序技术）的应用为骨血管肿瘤提供了新的诊断标志物，并为进一步细化分类创造了条件。目前文献中关于脊柱上皮样血管瘤的病例报道极少，因此难以为此类患者制定基于证据的治疗决策。本文报告我们诊治的11例脊柱上皮样血管瘤患者的临床经验。研究人群包括2016年至今在我中心接受治疗的三名男性和八名女性，平均年龄44.8岁（范围14-75岁）。我们对手术、临床及影像学资料进行了回顾性分析，平均随访时间为34.8个月。所有患者均表现为椎体溶骨性病变，其中六例伴有病理性骨折。多数患者（80%）出现脊髓神经根压迫症状。所有患者均接受手术治疗，且所有病例均行术前栓塞治疗。结合文献综述及本中心的临床经验，我们认为上皮样血管瘤属于局部侵袭性肿瘤，出现症状时需手术治疗。本文提出了一套治疗流程，可能有助于管理这类罕见疾病患者。
肿瘤(癌症)患者之家