TITLE:
Lumbar Paraspinal Hemangiopericytoma, An Unusual Location: Surgery with Preoperative Embolization
AUTHORS:
Habib Abdoul Karim Ouiminga, Aminath Kelani, Denléwendé Sylvain Zabsonre, Anatole Jean Innocent Ouedraogo, Desire Harouna Sankara, Mengyou Li, Omar Salia, Souleymane Ouattara, Hongbo Wang
KEYWORDS:
Hemangiopericytoma, Embolization, Spine, Surgery
JOURNAL NAME:
World Journal of Neuroscience,
Vol.11 No.2,
April
27,
2021
ABSTRACT: Background: Lumbar paraspinal hemangiopericytoma is rare. The hemorrhagic nature of
the tumor causes problems of hemostasis and makes the resection delicate. We
report a rare case of lumbar paraspinal hemangiopericytoma managed with
preoperative embolization. Clinical Case: It is about a woman of 31
years, admitted for a large left lumbar paraspinal mass that evolved for 6
years. The clinical exam showed an asymmetry of the left paraspinal muscle. The
mass painless was extended from the lumbar region. The neurological exam was
normal. MRI showed the left large paraspinal mass tissue. It was extended from
lumbar vertebrae, L1 to L4, and measured 100 × 50 × 50 mm. It was an
iso-intense signal on T1-weighted with strong enhancement after gadolinium. It
was hypervascular and supplied by left intercostal T12, L1, and L2 pedicles.
The complete exclusion of the hyper-vascular left paraspinal tumor was obtained
after selective embolization of the artery left L1 of the pedicle of the
intercostal left L1 and trunks intercostal T12 and L2 left. The total resection
of a mass encapsulated was performed. The operative outcome was good. The
histology concluded to a hemangiopericytoma. No chemotherapy or radiotherapy
was prescribed. After 5 years, the patient was asymptomatic. MRI control
confirmed tumor resection with a residue at the level of the left
intervertebral foramen L1 - L2. Conclusion: Lumbar paraspinal hemangiopericytoma is an extremely rare tumor. Selective
preoperative embolization is recommended before the resection of large tumors
to reduce vascular supply. A follow-up extended for these patients is
necessary, given the frequency of recurrences.