EPITHELIOID SARCOMA OF THE SPINE - A CASE-REPORT

Study Design. This case report illustrates a patient presenting with s ciatica and diagnosed with epithelioid sarcoma involving the spine. Ob jectives. The treatment of this patient involved multiple mass resecti ons and decompressions of the spinal canal. Radio- and chemotherapy we re applied once a clear diagnosis was obtained. Summary of Background Data. Epithelioid sarcoma is a race tumor mainly arising in the extrem ities. Confusion with a benign inflammatory process are possible. Trea tment after histologic diagnosis involves wide resection. To our knowl edge, this report represents the first case of epithelioid sarcoma inv olving the spine. Methods. After initial discectomy, recurrent scarrin g and mass formation required multiple decompression procedures and fu sion. The initial pathology revealed inflammatory reaction on fibrosis . In a later procedure, the histologic diagnosis of epithelioid sarcom a was made. Radiotherapy and chemotherapy were begun immediately. Resu lts. Despite aggressive resections, radiotherapy, and chemotherapy, th e patient died 3 months after the last surgical procedure. Conclusion. Spinal epithelioid sarcoma can be mistaken far a benign inflammatory process. After a histologic diagnosis, aggressive wide resection is ne cessary. Multiple recurrences are documented with this tumor in other sites. Prognosis in trunk involvement is less favorable than involveme nt of the extremities. The role of adjuvant radio- and chemotherapy is unclear for spinal involvement.