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Successful Removal After Radiotherapy
and Vascular Embolization in a Huge Tentorial Epithelioid Hemangioendothelioma:
A Case Report
Toshihiko Kubota, Kazufumi Sato, Hiroaki Takeuchi, Yuji
Handa
Department of Neurosurgery, Faculty of
Medical Sciences, Fukui University, Matsuoka, Fukui, Japan
Intracranial epithelioid hemangioendothelioma (E-HE) is an extremely
rare, vasoformative tumor with variable biological behavior.
A huge E-HE confined to the upper side of the tentorium has not been documented
previously.
Recognizing E-HE as a specific vascular tumor is important, and complete tumor
removal guarantees long-term survival.
Here, we report an intracranial E-HE of a 24-year-old woman with the initial
symptoms of progressive headache over several years.
Magnetic resonance imaging revealed a huge tumor attached to the upper side of
the right tentorium, with tentorial and tonsillar herniation, and secondary
syringomyelia in the upper cervical spinal cord.
The initial surgical attempt to remove the lesion was abandoned due to profuse
bleeding from the tumor.
One year after irradiation and 5 days after vascular embolization, the tumor
could be removed totally.
The final definitive diagnosis as E-HE was made by special immunohistochemical
and electron microscopic study.
The patient is free from the tumor 9 years after the second operation.
Thus, E-HE is a highly vascular-rich tumor to excise, and we stress need for
preoperative embolization and/or irradiation to remove huge tumor completely.
Keywords: hemangioendothelioma, radiotherapy, tentorium, vascular embolization
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://journals.kluweronline.com/article.asp?PIPS=5270379
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