Epidural spinal cavernous hemangioma and hybrid vascular subtype

To demonstrate less common pathologies of purely epidural spinal tumors that should be considered when noted on MRI prior to surgery. To expand the differential diagnosis of purely epidural spinal tumors and comment on their surgical implications.

We report on two patients from our institution with rare pathology. We also utilized PubMed to concisely review the literature concerning purely epidural vascular lesions akin to the cavernous hemangioma.

We describe common clinical presentations, radiographic findings, histopathologic characteristics and treatment algorithms relevant to the rare pure spinal epidural cavernous hemangioma and a newly described compound hemangioma subtype.

Epidural spinal tumors are relatively common entities, though lesions isolated to the epidural space without origination in the vertebral body or as part of neurologic presentation of metastatic disease, are much less common. Less common pathologies may be missed in the initial differential diagnosis with treatment implications at surgery.