Disclosures: Ishaan Hublikar, DO: No financial relationships or conflicts of interest

Case Diagnosis: A 69-year-old male with recurrence of thoracic hemangiopericytoma and worsening non-traumatic spinal cord injury, incomplete paraplegia

Case Description: Patient is a 69-year-old male with history of a non-traumatic spinal cord injury (NTSCI), T11 [American Spinal Injury Association (ASIA) Impairment Scale (AIS)] D incomplete paraplegia secondary to thoracic hemangiopericytoma status-post multiple resections, found to have a new enhancing lesion at T6-T8. He was initially diagnosed with a hemangiopericytoma in 2001 but had new T2-T3 and T10 intradural and extramedullary lesions found in 2018. After tumor resection and laminectomy in 2018, he underwent acute inpatient rehabilitation (AIR) for NTSCI at T11 AIS D and progressed to community ambulation with a rolling walker. Routine surveillance imaging in 2020 showed a new enhancing T6-T8 lesion different from two years prior. After undergoing T6-T8 laminectomy for tumor resection, he had decreased strength and sensation in his bilateral lower extremities. A repeat spinal cord injury classification during AIR demonstrated new T6 AIS C incomplete paraplegia. The second AIR admission focused on goals of independence at a wheelchair level given his greater lower extremity weakness.

Setting: Tertiary Care HospitalAssessment/

Results: The patient was initially moderate/total assist for most activities of daily living (ADLs), but improved to minimum/moderate assist for most tasks by discharge. Given the significant change in his mobility from using a rolling walker to then requiring a power wheelchair, he benefited from psychological support.

Discussion: Hemangiopericytomas rarely occur in the spine, with few studies describing their spinal cord effects causing impaired mobility and ADLs. This case report highlights recurrence of these tumors presenting long-term obstacles, despite surgical treatment. Routine surveillance imaging allowed detection of new lesions.

Conclusion: This case illustrates the multi-faceted complications from hemangiopericytoma recurrence and the significance that an interdisciplinary rehab program plays in treating and supporting a chronic SCI patient who experiences worsening neurological deficits.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/thoracic-hemangiopericytoma-recurrence-a-spinal-cord-injury-case-report/