En bloc spondylectomy for primary malignant fibrous histiocytoma of the thoracic spine with aortic involvement: case report

J Neurosurg Spine. 2015 Apr;22(4):399-405. doi: 10.3171/2014.9.SPINE14155. Epub 2015 Feb 6.

Abstract

In this article, the authors describe a 48-year-old man who initially presented with progressively worsening back pain. Magnetic resonance imaging revealed a soft-tissue mass involving the T10-11 vertebral bodies with extension anteriorly into the aorta as well as epidural extension without spinal cord compression. A biopsy of the mass showed findings consistent with a malignant fibrous histiocytoma (MFH). A total en bloc spondylectomy with resection and reconstruction of the involved aorta using a vascular graft was performed. The patient received postoperative radiation therapy and is neurologically intact at 18 months postoperatively. To the authors' knowledge, this is the first reported case of a spinal MFH resection with aortic reconstruction.

Keywords: MEP = motor evoked potential; MFH = malignant fibrous histiocytoma; SSEP = somatosensory evoked potential; aortic reconstruction; malignant fibrous histiocytoma; mediastinal mass; neoadjuvant chemotherapy; oncology; thoracic spinal tumor.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Thoracic / pathology*
  • Aorta, Thoracic / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Combined Modality Therapy
  • Follow-Up Studies
  • Histiocytoma, Malignant Fibrous / pathology*
  • Histiocytoma, Malignant Fibrous / radiotherapy
  • Histiocytoma, Malignant Fibrous / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neurologic Examination
  • Postoperative Complications / diagnosis
  • Radiotherapy, Adjuvant
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / radiotherapy
  • Spinal Neoplasms / surgery*
  • Thoracic Vertebrae / pathology*
  • Thoracic Vertebrae / surgery*