Epithelioid sarcoma of lumbar spine: A rare mesenchymal tumor masquerading as infection

Abstract

Epithelioid sarcoma of the spine has been rarely reported in the literature. Its diagnosis is challenging due to nonspecific findings. We report a case of 42-year-old gentleman with back pain. Magnetic resonance imaging (MRI) revealed lesion in the L4 vertebral body extending into the spinal canal with pre and paravertebral involvement. He underwent posterior spinal decompression and instrumentation with biopsy. Histopathological examination was nonspecific. Considering clinical and radiological features, antitubercular treatment was initiated. The patient developed acute onset weakness of both lower extremities 1 month post-surgery. Repeat MRI and positron emission tomography (PET) computed tomography revealed an increase in the extent of lesion which required revision decompression. Histopathological examination showed cells with epithelioid appearance, positive for Vimentin, and epitheloid membrane antigen in immunohistochemistry. Radiotherapy was planned but the patient expired due to multiorgan dysfunction. Epithelioid sarcomas are rare soft-tissue neoplasms with poor prognosis. They can mimic infection and a high degree of suspicion is required in these cases to diagnose and treat them early.

Epithelioid Sarcoma of the Spine: A Review of Literature and Case Report

“…ES of the spine is extremely rare. In the reviewed literature, ES typically presented as a large mass in the paravertebral space with or without intraspinal extension [6,7,[26][27][28][29][34][35][36][37]. However, in our case, the lesion was predominantly intradural and intramedullary with perineural extension along the T1 nerve root without a large paravertebral component.…”

Effects of LncRNA GAS5/miR-137 general anesthesia on cognitive function by TCF4 inflammatory bodies in patients undergoing lumbar spinal canal decompression

“…As a common orthopedic disease, lumbar spinal stenosis frequently occurs among middle-aged and elderly people. [ 19 ] With the intensification of population aging and the continuous change of lifestyle, its incidence has been increasing year by year, which seriously threatens people’s quality of life. [ 2 , 20 ] Currently, surgery is the main treatment for patients with lumbar spinal stenosis.…”