TITLE:
Spinal Epidural Cavernous Hemangioma of the Thoracic Spine: A Case Report
AUTHORS:
Ryoichi Fukano, Yasuaki Iida, Keiji Hasegawa, Yuichirou Yokoyama, Akihito Wada, Shigeta Takeuchi, Kazutoshi Shibuya, Hiroshi Takahashi
KEYWORDS:
Epidural Cavernous Hemangioma, Thoracic Spine, Myelopathy
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.5 No.10,
October
20,
2015
ABSTRACT: Cavernous
hemangiomas can arise in any region of the body, including the central nervous
system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of
vertebral vascular malformation. Most of these are of vertebral origin, and
cases that are non-vertebral in origin are rare. We encountered a patient with
a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that was non-vertebral in origin. The
patient was a 63-year-old man. He had become aware of bilateral leg pain
and numbness about 2 months earlier, and gait disturbance appeared gradually thereafter.
On MRI, a lesion showing iso-intensity on T1-weighted imaging and high intensity
on T2-weighted imaging was detected at the 7th thoracic vertebra. On
gadolinium contrast-imaging, the lesion was
found to be a homogenously-enhanced dumbbell-shaped extradural spinal neoplasm protruding from the left 7th/8th thoracic intervertebral foramen. A neurogenic tumor was suspected based
on myelography and MRI findings, and complete tumorectomy was performed, which
improved the lower limb symptoms and gait disturbance. The histopathological
diagnosis was cavernous hemangioma. Epidural
hemangiomas arise from the vertebra in many cases, and pure spinal
epidural cavernous hemangiomas are rare. It is difficult to make a preoperative
diagnosis because there are no specific imaging findings that can differentiate
these tumors. It may be important to consider this disease before surgery in
the differential diagnosis of epidural tumors.