Epithelioid sarcoma of the spine: a case report and review

Jeong Hyun Yoo
DOI: 10.4236/ojcd.2011.11001                

Abstract

Epithelioid sarcoma is a rare malignant soft tissue neoplasm commonly involving extremities of young adults and rarely occurring in the trunk area. It re-sembles a chronic inflammatory process and mimics benign reactive granuloma or other benign diseases. Despite its indolence and slow growth, the prognosis is poor with high recurrence and early lymph node spreading and hematogeneous distant metastasis. Involvement of the spine is extremely rare and diffi-cult to diagnose correctly in clinical presentation and pathology. We describe our experience a case of epi-thelioid sarcoma involving lumbar spine. A pre-ope- rative spine MRI showed a large solid and necrotic paraspinal mass which extended into the spinal canal with cord compression, and bone destruction. Final correct diagnosis was confirmed by immunohisto-chemical studies. When young adults present with a spinal lesion that has unusual large necrotic soft tissue mass, immunohistochemical studies are recommended for promptly determining the possibility of spinal epithelioid sarcoma.

Keywords

Sarcoma; Epithelioid: Spine; Neoplasm: MR Image

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Chase DR, Enzinger FM. (1985) Epithelioid sarcoma. Diagnosis, prognostic indicators, and treatment. Am J Surg Pathol. 9, 241-263.
[2]	Bos GD, Pritchard DJ, Reiman HM, Dobyns JH, Ilstrup DM, Landon GC.(1988) Epithelioid sarcoma. An analysis of fifty-one cases. J Bone Joint Surg Am. 70, 862-870.
[3]	Halling AC, Wollan PC, Pritchard DJ, Vlasak R, Nascimento AG. (1996) Epithelioid sarcoma: a clinicopathologic review of 55 cases. Mayo Clin Proc. 71, 636- 642.
[4]	Kodet R, Smelhaus V, Newton WA, Jr., et al. (1994) Epithelioid sarcoma in childhood: An immunohistochemical, electron microscopic, and clinicopathologic study of 11 cases under 15 years of age and review of the literature. Pediatr Pathol. 14, 433-451.
[5]	Steinberg BD, Gelberman RH, Mankin HJ, Rosenberg AE. (1992) Epithelioid sarcoma in the upper extremity. J Bone Joint Surg Am. 74, 28-35.
[6]	Prat J, Woodruff JM, Marcove RC. (1978) Epithelioid sarcoma: an analysis of 22 cases indicating the prognostic significance of vascular invasion and regional lymph node metastasis. Cancer. 41, 1472-1487.
[7]	Romero JA, Kim EE, Moral IS.(1994) MR characteristics of epithelioid sarcoma. J Comput Assist Tomogr. 18, 929-931.
[8]	Ross HM, Lewis JJ, Woodruff JM, Brennan MF. (1997) Epithelioid sarcoma: clinical behavior and prognostic factors of survival. Ann Surg Oncol. 4, 491-495.
[9]	Steib JP, Pierchon F, Farcy JP, Lang G, Christmann D, Gnassia JP. (1996) Epithelioid sarcoma of the spine: a case report. Spine. 21, 634-638.
[10]	Weisskopf M, Munker R, Hermanns-Sachweh B, Ohnsorge JA, Siebert C. (2006) Epithelioid sarcoma in the thoracic spine. Eur Spine J. 15, Suppl 5: 604-609.
[11]	Yamato M, Nishimura G, Yamaguchi T, Tamai K, Saotome K. (1997) Epithelioid sarcoma with unusual radiological findings. Skeletal Radiol. 26, 606-610.
[12]	Kawai A, Hasizume H, Sugihara S, Morimoto Y, Inoue H. (2002) Treatment of bone and soft tissue sarcomas of the hand and wrist. Int Orthop. 26, 26-30.