Surgical management of primary osseous thoracic spine hemangiopericytoma in a low resource setting: A case report

Abstract

Hemangiopericytoma is a rare vascular neoplasm that arises from pericytes (Zimmermann cell) around the capillary wall. Primary osseous hemangiopericytoma is even rarer, with a high propensity of recurrence and distance metastasis. The management of this tumor is challenging in limited resource setting. We present a case of a 45 years old patient who presented at our clinic complaining of worsening of a chronic back pain, without any neurological impairment. CT scan and MRI revealed a heterogeneous lesion of the vertebral body and left isthmus of T11, with lysis of the posterior wall of the vertebral body and dural sac compression. Piecemeal total spondylectomy of T11 was performed in a two-stage operation through anterior and posterior approaches. The postoperative course was uneventful, with satisfactory clinical outcome and no recurrence 12 months following surgery. In resource limited setting, where total en bloc spondylectomy is very challenging, piecemeal total resection with adjuvant radiotherapy is a reliable option.