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Pure epidural spinal cavernous haemangioma
Ragavan Manoharan1, Jonathon Parkinson1
1Department of Neurosurgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Background:
Pure epidural spinal cavernous hemangiomas (SCH) account for only 4% of all spinal epidural lesions. Our literature review identified 61 publications reporting on, a total of 175 cases in the magnetic resonance imaging era. Here, we reviewed those cases, and have added our case of what appeared to be a multifocal SCH.
Case Description:
A 72-year-old male presented with a progressive paraparesis attributed to a T5/T6 dorsolateral extradural mass extending into the right T5/6 foramen. Surgical excision documented the lesion, histologically, was a SCH. A second similar lesion was noted involving the left C7/T1 foramen; as the patient was asymptomatic from this lesion, and no additional biopsy was performed. The patient returned to normal neurological function within 2 months postoperatively.
Conclusions:
Here, a 72-year-old male presented with a pathologically confirmed T5/T6 epidural SCH and a secondary C7/T1 foraminal lesion suspected to represent a secondary focus of an epidural SCH.
Insights
Spinal cavernous hemangiomas (SCH) are rare epidural lesions. This case report details a multifocal SCH in a 72-year-old male, highlighting diagnosis and successful surgical management.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Spinal cavernous hemangiomas (SCH) are rare, comprising only 4% of spinal epidural lesions.
- A literature review identified 175 cases of SCH reported during the magnetic resonance imaging era.
- This study contributes an additional case, potentially representing a multifocal presentation of SCH.
Observation:
- A 72-year-old male presented with progressive paraparesis due to a T5/T6 dorsolateral extradural mass.
- Histological examination confirmed the T5/T6 lesion as a spinal cavernous hemangioma (SCH).
- A second, asymptomatic lesion was identified at the left C7/T1 foramen, suspected to be a multifocal SCH.
Findings:
- Surgical excision of the symptomatic T5/T6 epidural SCH resulted in complete neurological recovery within 2 months.
- The presence of a second, asymptomatic lesion suggests the possibility of multifocal spinal cavernous hemangiomas.
- This case expands the understanding of SCH presentation and management.
Implications:
- Early diagnosis and surgical intervention are crucial for managing symptomatic spinal cavernous hemangiomas.
- The potential for multifocal SCH warrants thorough spinal imaging in affected patients.
- This case underscores the importance of considering rare spinal tumors in the differential diagnosis of extradural lesions.
