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Aggressive vertebral hemangiomas in children

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Abstract

Background

Aggressive vertebral hemangiomas are rare tumors in children, usually occurring in the thoracic spine that can cause significant neurological morbidity. They are technically difficult to treat with significant risk of blood loss during surgery.

Methods

We describe a case of aggressive vertebral hemangioma managed in our institution. We performed a literature review of reported cases of aggressive vertebral hemangiomas in pediatric age group. We discuss the clinical presentation, diagnosis, and management of these lesions.

Results

We identified 23 cases of aggressive vertebral reported in children. Neurodeficit was the most common presentation, and the most common location was the thoracic spine. Surgery was the most common modality of treatment. All the patients reported in literature had improvement in their symptoms after treatment.

Conclusion

Although technically challenging, aggressive vertebral hemangiomas have a good outcome after treatment. Treatment should be tailored to the individual patient. Further studies are needed to determine the optimum treatment strategy.

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References

  1. Cloran FJ, Pukenas BA, Loevner LA et al (2015) Aggressive spinal haemangiomas: imaging correlates to clinical presentation with analysis of treatment algorithm and clinical outcomes. https://doi.org/10.1259/bjr.20140771

    Article  Google Scholar 

  2. Issa M, Lucas G, Violas P et al (2015) Vertebroplasty for vertebral hemangioma in children: a report of two cases with 2-year follow-up. Childs Nerv Syst 31:2179–2183. https://doi.org/10.1007/S00381-015-2777-4

    Article  PubMed  Google Scholar 

  3. Sahajwalla D, Vorona G, Tye G et al (2021) Aggressive vertebral hemangioma masquerading as neurological disease in a pediatric patient. Radiol case reports 16:1107–1112. https://doi.org/10.1016/J.RADCR.2021.02.023

    Article  Google Scholar 

  4. Vasudeva VS, Chi JH, Groff MW (2016) Surgical treatment of aggressive vertebral hemangiomas. Neurosurg Focus 41. https://doi.org/10.3171/2016.5.FOCUS16169

  5. Manning HJ (1951) Symptomatic Hemangioma of the Spine1. 56:58–65. https://doi.org/10.1148/56.1.58

  6. Kim Y, Taihi L, Viry F et al (2020) Aggressive vertebral hemangioma: a post-bioptic finding, the gas web sign-report of two cases. BJR case reports 6:20190091. https://doi.org/10.1259/BJRCR.20190091

    Article  PubMed  PubMed Central  Google Scholar 

  7. Robinson Y, Sheta R, Salci K, Willander J (2015) Blood loss in surgery for aggressive vertebral haemangioma with and without embolisation. Asian Spine J 9:483. https://doi.org/10.4184/ASJ.2015.9.3.483

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hekster REM, Luyendijk W, Tan TI (1972) Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation. Neuroradiology 3:160–164. https://doi.org/10.1007/BF00341502

    Article  CAS  PubMed  Google Scholar 

  9. Raco A, Ciappetta P, Artico M et al (1990) Vertebral hemangiomas with cord compression: the role of embolization in five cases. Surg Neurol 34:164–168. https://doi.org/10.1016/0090-3019(90)90067-Y

    Article  CAS  PubMed  Google Scholar 

  10. Smith TP, Koci T, Mehringer CM et al (1993) Transarterial embolization of vertebral hemangioma. J Vasc Interv Radiol 4:681–685. https://doi.org/10.1016/S1051-0443(93)71948-X

    Article  CAS  PubMed  Google Scholar 

  11. Kiroglu Y, Benek B, Yagci B et al (2009) Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy. Surg Neurol 71:487–492. https://doi.org/10.1016/J.SURNEU.2007.09.025

    Article  PubMed  Google Scholar 

  12. Heiss JD, Doppman JL, Oldfield EH (1994) Relief of spinal cord compression from vertebral hemangioma by intralesional injection of absolute ethanol. 331:508–511. https://doi.org/10.1056/NEJM199408253310804

  13. Goyal M, Mishra NK, Sharma A et al (1999) Alcohol ablation of symptomatic vertebral hemangiomas. AJNR Am J Neuroradiol 20:1091–1096

  14. Doppman JL, Oldfield EH, Heiss JD (2000) Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol1. 214:341–348. https://doi.org/10.1148/RADIOLOGY.214.2.R00FE46341

  15. Singh PK, Chandra PS, Vaghani G et al (2016) Management of pediatric single-level vertebral hemangiomas presenting with myelopathy by three-pronged approach (ethanol embolization, laminectomy, and instrumentation): a single-institute experience. Childs Nerv Syst 32:307–314. https://doi.org/10.1007/S00381-015-2941-X

    Article  PubMed  Google Scholar 

  16. Djindjian M, Nguyen JP, Gaston A et al (1992) Multiple vertebral hemangiomas with neurological signs. Case report J Neurosurg 76:1025–1028. https://doi.org/10.3171/JNS.1992.76.6.1025

    Article  CAS  PubMed  Google Scholar 

  17. Fox MW, Onofrio BM (1993) The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg 78:36–45. https://doi.org/10.3171/JNS.1993.78.1.0036

    Article  CAS  PubMed  Google Scholar 

  18. Jiang L, Liu XG, Yuan HS et al (2014) Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review. Spine J 14:944–954. https://doi.org/10.1016/J.SPINEE.2013.07.450

    Article  PubMed  Google Scholar 

  19. Yang ZY, Zhang LJ, Chen ZX, Hu HY (1985) Hemangioma of the vertebral column. A report on twenty-three patients with special reference to functional recovery after radiation therapy. Acta Radiol Oncol 24:129–132. https://doi.org/10.3109/02841868509134375

    Article  CAS  PubMed  Google Scholar 

  20. Asthana AK, Tandon SC, Pant GC et al (1990) Radiation therapy for symptomatic vertebral haemangioma. Clin Oncol 2:159–162. https://doi.org/10.1016/S0936-6555(05)80151-7

    Article  CAS  Google Scholar 

  21. Cherian J, Sayama CM, Adesina AM et al (2014) Multilevel thoracic hemangioma with spinal cord compression in a pediatric patient: case report and review of the literature. Childs Nerv Syst 30:1571–1576. https://doi.org/10.1007/S00381-014-2441-4

    Article  PubMed  Google Scholar 

  22. Uzunaslan D, Saygin C, Gungor S et al (2013) Novel use of propranolol for management of pain in children with vertebral hemangioma: report of two cases. Child’s Nerv Syst 295(29):855–860. https://doi.org/10.1007/S00381-012-2012-5

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, 751019, India

    Arunkumar Sekar, Debajyoti Datta,  Parameshwar & Sumit Bansal

  2. Department of Pediatrics, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, 751019, India

    Krishna Mohan Gulla

Authors
  1. Arunkumar Sekar
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  2. Debajyoti Datta
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  3. Parameshwar
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  4. Krishna Mohan Gulla
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  5. Sumit Bansal
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Contributions

Arunkumar Sekar: patient care and preparation of the final draft, Debjyothi Datta: first draft preparation, review of literature, and patient care, Parameshwar: review of literature and patient care, Krishna Mohan Gulla: patient care and final draft review, Sumit Bansal: patient care and final draft review.

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Correspondence to Arunkumar Sekar.

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Sekar, A., Datta, D., Parameshwar et al. Aggressive vertebral hemangiomas in children. Childs Nerv Syst 39, 571–575 (2023). https://doi.org/10.1007/s00381-022-05760-9

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