Turkish Neurosurgery
2015 , Vol 25 , Num 3
Embolization in the Treatment of an Intraosseous Glomus Tumor in the Upper Thoracic Spine Complicating Compression Myelopathy: A Case Report and A Literature Review
Changzheng Hospital, Second Military Medical University, Department of Orthopedic Oncology, Shanghai, China
DOI :
10.5137/1019-5149.JTN.7854-12.1
Glomus tumors are very infrequent in the spine. The lesions can grow intraosseously along the entire spinal axis. A single female presenting
with back pain from the upper thoracic spine is reported on. Removal of this lesion may require reconstruction of the anterior column with
posterior fixation resulting in significant blood loss. The current report describes an embolization procedure prior to removal in order to reduce
the significant blood loss that occurs with removal of this lesion, and summarizes the clinical and pathological characteristics of this rare
tumor. A single, recent case and removal of an intraosseous tumor arising from the upper thoracic vertebra of T2-T4 is described. A 45-year-old
female presenting with symptoms secondary to a glomus tumor of the upper thoracic vertebra of T2-T4 underwent resection of the lesion
followed by reconstruction of the anterior column following preoperative emobolization. She had neurological symptoms for 3 years, and an
irregular crescent-shaped lesion was seen going through the foramen at T3 to the chest cavity in the MRI scans. The operation was performed
with a posterior approach in a single stage. The use of preoperative embolization of the T2-T4 segmental arteries resulted in significantly less
blood loss as compared to without an embolization procedure. It was confirmed by histopathological examination that the glomus tumor
rose from the smooth muscle cells in the right paravertebral muscles of T2. The glomus tumor has not recurred in the MRI during the five-year
follow-up. Intraosseous glomus tumors are rare lesions that may extend into the epidural space and through the neural foramina and chest
compartments resulting in neurological compromise. Over time, they may grow very large. Radiotherapy can be useful for eradication of
this rare lesion. However, it can reoccur requiring extensive surgery resulting in significant blood loss. Preoperative embolization results in a
reduction of blood loss and can be a very useful technique when performing the resection of large lesions suspected to be glomus tumors.
Keywords :
Embolization, Intraosseous glomus tumor, Upper thoracic spine