Multifocal spinal angiosarcoma after chordotomy

Abstract

A male aged 60 is reported who, 5 years after chordotomy at the Th 2/3 level, developed acute paraplegia of the legs and a sensory transverse lesion due to an extradural tumour of the Th 1-4 level. Neuropathology revealed transverse necrosis of the thoracic spinal cord (Th 1-4) due to an intradural tumour at the upper thoracic and lumbar spinal levels, the thoracic malignancy arising at the site of the previous chordotomy, with a suture being observed within the tumour mass. Histology, positive immunostaining of tumour cells with Factor VIII antigen, a specific marker of endothelial cells and the ultrastructural demonstration of Weibel-Palade bodies in endothelial cells of the tumour vessels suggested a malignant mesenchymal tumour of angiosarcoma type presumably arising from the spinal meninges, and broadly invading the spinal cord. The usual relation of this extremely rare intraspinal vasoformative malignancy to previous chordotomy is discussed.