Rare Spine Tumor Threatened Teen’s Ability to Walk

Last fall, Ryan Soliz was a healthy high school senior, finishing college applications and preparing for another season on the golf team, when a nagging pain in his back began to interfere with his swing-and then his ability to walk.

Soliz initially shrugged it off as a pulled muscle. But the pain grew progressively worse. Soon, he was experiencing sharp pain throughout the day, using walls for support as he walked and struggling to find a comfortable position to sleep.

Soliz underwent an MRI, revealing a large tumor in his spine. Recognizing the critical diagnosis of this bone tumor, an orthopedic surgeon in Ventura County near Soliz's home referred him to Cedars-Sinai.

An image-guided biopsy performed by interventional neuroradiologist Marcel Maya, MD, co-chair of the Department of Imaging at Cedars-Sinai, made the diagnosis of an aneurysmal bone cyst, a rare, blood-filled tumor that can grow rapidly and, as in Soliz's case, destabilize the spinal column and compress the spinal cord.

Although the tumor was benign, its location made it dangerous, said his surgeon, Tiffany Perry, MD, associate professor of Neurosurgery and co-director of Spine Oncology.

"Spinal fluid normally surrounds the cord, providing space for the cord and the nerve roots as they exit the spinal column," Perry said. "But in Ryan's case, the tumor was taking up about 80% of the spinal canal and was blocking the flow of fluid and compressing the cord, causing weakness in his legs."

For Soliz, the diagnosis quickly became about more than treating a rare tumor-it was about saving his ability to walk. Three days after his outpatient appointment in the neurosurgery clinic, Soliz began losing feeling in his legs, prompting doctors to act emergently. By the time he was admitted to the ICU, he had lost the ability to walk.

"It was a roller coaster of emotions. I was terrified thinking I might never be able to walk again," Soliz said.

A Rare Tumor and Emergency Surgery

Aneurysmal bone cysts are uncommon, and involvement of the spine with significant spinal cord compression is particularly unusual, Maya said.

"Although these tumors are benign, they can be locally very aggressive-destroying bone, bleeding significantly and, when they occur in the spine, compressing the spinal cord," Maya said.

After Soliz was seen in the outpatient clinic, his case was reviewed by a spine tumor board, a group of specialists at Cedars-Sinai from different disciplines that discusses complex spinal tumors. The board ensures patients like Soliz receive coordinated care, formulating a comprehensive, individualized treatment plan for each patient. Maya said the multidisciplinary tumor board allows specialists in neurosurgery, imaging, interventional neuroradiology, pathology and other disciplines to develop a coordinated treatment strategy from the outset. Given the rapid decline of Soliz's condition, his care team implemented the developed plan in an expedited manner.

Before removal of the tumor, Michael Alexander, MD, vice chair of Neurosurgery, performed a preoperative embolization of the tumor. This minimally invasive procedure blocked blood flow to the tumor, reducing the risk of major blood loss during surgery.

Following the embolization, Perry resected the tumor during a five-hour surgery, ultimately relieving the pressure on Soliz's spinal cord and preserving his ability to walk.

In addition to Perry, Maya and Alexander, many Cedars-Sinai specialists contributed to Soliz's care, including the pathologists who confirmed his diagnosis. The specialists and staff in the Neuroscience Critical Care Unit were also instrumental in his recovery, providing attentive care before and after surgery that helped him begin walking again.

"Ryan's case reflects the importance of every team bringing its expertise together toward one shared goal-taking care of every patient and ensuring the best outcomes possible within our abilities," Perry said.

A Recurrence, and Off to College

After surgery, Soliz spent time in rehabilitation recovering his strength. But in April, the tumor returned.

Alexander performed another embolization, blocking the blood vessels supplying the tumor. The approach allowed Soliz to avoid another operation to remove it and instead take medication to suppress the tumor's growth.

Today, Soliz is in good health, golfing and hiking, and preparing to start his freshman year at the University of Hawaii, where he will be followed by a specialist throughout the school year. During breaks, he will continue his medical care at Cedars-Sinai.

Despite everything he has been through, Soliz is looking ahead to college and to a possible career in healthcare.

"I've always had huge respect for healthcare workers, but being a patient made me realize I want to work in healthcare and help others as a nurse," he said.

For Perry, Soliz's story feels personal.

"I have a daughter one year older than Ryan who just went through the college application process and moved away," Perry said. "I could only imagine what Mrs. Soliz was feeling. I knew we had to work together for Ryan. He has amazing things he will do-and I cannot wait to see how he changes the world."

Read more from Cedars-Sinai Stories and Insights: Seeking a Second Opinion for a Spine Condition