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Primary spinal angiosarcoma is extremely rare with few reported cases globally. While en bloc resection is the only definitive and curative treatment modality, this case highlights the potential for curative-intent, non-surgical management of spinal epithelioid angiosarcoma using taxane-based chemoradiotherapy, especially in anatomically challenging and surgically unresectable locations. It also emphasises the role of multimodal imaging and histopathological correlation in the diagnosis and monitoring of rare spinal tumours.