{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:32:38Z","timestamp":1783773158755,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2021MH254"],"award-info":[{"award-number":["ZR2021MH254"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Vertebral hemangiomas (VH), the most prevalent benign spinal tumors, often remain asymptomatic for many years or even a lifetime. Symptomatic cases are rare, constituting only 0.9%\u20131.2% of cases. Approximately 55% of symptomatic VH cases present with pain as the sole manifestation, whereas the remaining 45% exhibit aggressive characteristics and are classified as aggressive vertebral hemangiomas (AVH). AVH may invade the spinal canal and\/or paravertebral space, potentially causing spinal cord compression and nerve damage, thus requiring active treatment. Despite various treatment options available for AVH, a consensus on the optimal therapeutic strategy is yet to be established owing to its rarity. We report a case of AVH who presented with symptoms of spinal cord compression treated using combination therapy of preoperative arterial embolization, intraoperative vertebroplasty, and total laminectomy with spinal canal decompression. This approach was tailored to the patient\u2019s poor physical condition and yielded satisfactory clinical outcomes at 12-month follow-up. Combination therapy maximized synergistic benefits and leveraged the advantages of each procedure, thus achieving enhanced therapeutic effects and reducing risks. Given an aging population, tailoring combination therapy for AVH to individual patient characteristics merits broader clinical adoption.<\/jats:p>","DOI":"10.3389\/fonc.2025.1632237","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:17:35Z","timestamp":1761106655000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Managing aggressive vertebral hemangiomas with combination therapy: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Zetao","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhu","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aokang","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yungang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.11.003","article-title":"Intraoperative vertebroplasty during surgical decompression and instrumentation for aggressive vertebral hemangiomas: a retrospective study of 39 patients and review of the literature","volume":"18","author":"Wang","year":"2018","journal-title":"Spine J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4022-y","article-title":"Vertebral hemangiomas: their demographical characteristics, location along the spine and position within the vertebral body","volume":"24","author":"Slon","year":"2015","journal-title":"Eur Spine J"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2023.100515","article-title":"Surgical Options for Aggressive Vertebral Hemangiomas:A case series, literature review and treatment recommendations","volume":"43","author":"Diarra","year":"2023","journal-title":"J Bone Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2016.5.FOCUS16169","article-title":"Surgical treatment of aggressive vertebral hemangiomas","volume":"41","author":"Vasudeva","year":"2016","journal-title":"Neurosurg Focus"},{"key":"B5","doi-asserted-by":"publisher","first-page":"199","DOI":"10.4103\/0973-1482.65248","article-title":"Symptomatic vertebral hemangioma: treatment with radiotherapy","volume":"6","author":"Aich","year":"2010","journal-title":"J Cancer Res Ther"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(85)90162-2","article-title":"Radiotherapy in the treatment of vertebral hemangiomas","volume":"11","author":"Faria","year":"1985","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B7","article-title":"Irradiation therapy of vertebral angionomas: results in 62 patients during the years 1939 to 1975 (author\u2019s transl)","volume":"153","author":"Glanzmann","year":"1977","journal-title":"Strahlentherapie"},{"key":"B8","doi-asserted-by":"publisher","first-page":"E99","DOI":"10.1097\/BRS.0000000000003181","article-title":"Surgical management and adjuvant therapy for patients with neurological deficits from vertebral hemangiomas: A meta-analysis","volume":"45","author":"Piper","year":"2020","journal-title":"Spine (Phila Pa 1976)"},{"key":"B9","article-title":"The efficacy of radiotherapy for vertebral hemangiomas","volume":"48","author":"Miszczyk","year":"2001","journal-title":"Neoplasma"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1080150","article-title":"Percutaneous vertebroplasty","volume":"1","author":"Deramond","year":"1997","journal-title":"Semin Musculoskelet Radiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/s0033-8389(05)70042-7","article-title":"Percutaneous vertebroplasty with polymethylmethacrylate. 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