Skip to main content

Pure spinal epidural cavernous hemangioma

Acta Neurochirurgica volume 154, pages 739–745 (2012)Cite this article

Abstract

Background

Pure epidural cavernous hemangiomas without bony involvement are rare, representing 4% of all spinal epidural tumors. Most of these are case reports and are easily misdiagnosed.

Methods

Herein nine patients (male:female, 5:4, average age: 51 years) with symptomatic pure epidural spinal cavernous hemangioma between 2005 and 2011 were treated, and the clinical, radiological, and pathological records, treatment, and prognosis were discussed.

Results

All patients experienced a slowing progressive clinical course, except for one with intralesional hemorrhage. Clinical manifestations included back or radiating pain, sensorimotor deficits, and sphincters disturbance. Eight lesions were isointense on T1- and hyperintense on T2-weighted images with homogenously strongly enhancement and one was mixed signal with heterogeneous enhancement because of intratumoral hemorrhage. Hemilaminotomoy or laminotomy was performed and total resection was achieved. All patients experienced a gradual neurological improvement with no recurrence.

Conclusions

Spinal epidural cavernous hemangioma is a benign vascular malformation that should be excluded in the diagnosis of epidural lesion. Total surgical resection is recommended and usually results in a good prognosis.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Aoyagi N, Kojima K, Kasai H (2003) Review of spinal epidural cavernous hemangioma. Neurol Med Chir (Tokyo) 43(10):471–475

    Article  Google Scholar 

  2. Appiah GA, Knuckey NW, Robbins PD (2001) Extradural spinal cavernous haemangioma: case report and review of the literature. J Clin Neurosci 8(2):176–179

    PubMed  Article  CAS  Google Scholar 

  3. Bauland CG, van Steensel MA, Steijlen PM, Rieu PN, Spauwen PH (2006) The pathogenesis of hemangiomas: a review. Plast Reconstr Surg 117(2):29e–35e

    PubMed  Article  Google Scholar 

  4. Benny BV, Nagpal AS, Singh P, Smuck M (2011) Vascular causes of radiculopathy: a literature review. Spine J 11(1):73–85

    PubMed  Article  Google Scholar 

  5. Caruso G, Galarza M, Borghesi I, Pozzati E, Vitale M (2007) Acute presentation of spinal epidural cavernous angiomas: case report. Neurosurgery 60(3):E575–E576

    PubMed  Article  Google Scholar 

  6. Cervoni L, Celli P, Gagliardi FM (1995) Cavernous angioma of the cauda equina: report of two cases and review of the literature. Neurosurg Rev 18(4):281–283

    PubMed  Article  CAS  Google Scholar 

  7. Chi JH, Manley GT, Chou D (2005) Pregnancy-related vertebral hemangioma. Case report, review of the literature, and management algorithm. Neurosurg Focus 19(3):E7

    PubMed  Article  Google Scholar 

  8. D'Andrea G, Ramundo OE, Trillò G, Roperto R, Isidori A, Ferrante L (2003) Dorsal foramenal extraosseous epidural cavernous hemangioma. Neurosurg Rev 26(4):292–296

    PubMed  Google Scholar 

  9. El Khamary SM, Alorainy IA (2006) Case 100: spinal epidural meningioma. Radiology 241(2):614–617

    PubMed  Article  Google Scholar 

  10. Feng J, Xu YK, Li L, Yang RM, Ye XH, Zhang N, Yu T, Lin BQ (2009) MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas. Neuroradiology 51(11):741–747

    PubMed  Article  Google Scholar 

  11. Floeth F, Riemenschneider M, Herdmann J (2010) Intralesional hemorrhage and thrombosis without rupture in a pure spinal epidural cavernous angioma: a rare cause of acute lumbal radiculopathy. Eur Spine J 19(Suppl 2):S193–S196

    PubMed  Article  Google Scholar 

  12. Gao W, Qiao X, Ma S, Ma J, Dong X, Qin T, Fang Q (2011) Contribution of skin trauma to infantile skin hemangioma. Med Hypotheses 76(4):512–513

    PubMed  Article  Google Scholar 

  13. Gelabert-González M, García-Allut A (2009) Spinal extradural angiolipoma: report of two cases and review of the literature. Eur Spine J 18(3):324–335

    PubMed  Article  Google Scholar 

  14. Graziani N, Bouillot P, Figarella-Branger D, Dufour H, Peragut JC, Grisoli F (1994) Cavernous angiomas and arteriovenous malformations of the spinal epidural space: report of 11 cases. Neurosurgery 35(5):856–863

    PubMed  Article  CAS  Google Scholar 

  15. Hatiboglu MA, Iplikcioglu AC, Ozcan D (2006) Epidural spinal cavernous angioma. Neurol Med Chir (Tokyo) 46:455–458

    Article  Google Scholar 

  16. Inoue T, Koga H, Abe M, Tabuchi K (1995) Solitary spinal epidural cavernous haemangioma presenting as acute epidural haematoma. J Clin Neurosci 2(3):265–268

    PubMed  Article  CAS  Google Scholar 

  17. Mascalchi M, Torselli P, Falaschi F, Dal Pozzo G (1995) MRI of spinal epidural lymphoma. Neuroradiology 37(4):303–307

    PubMed  Article  CAS  Google Scholar 

  18. Nagi S, Megdiche H, Bouzaïdi K, Haouet S, Khouja N, Douira W, Sebaï R, Chaabene S, Zitouna M, Touibi S (2004) Imaging features of spinal epidural cavernous malformations. J Neuroradiol 31(3):208–213

    PubMed  Article  CAS  Google Scholar 

  19. Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP (1997) Cavernous angiomas of the spinal district: surgical treatment of 11 patients. Eur Spine J 6(5):298–303

    PubMed  Article  CAS  Google Scholar 

  20. Santoro A, Piccirilli M, Bristot R, di Norcia V, Salvati M, Delfini R (2005) Extradural spinal cavernous angiomas: report of seven cases. Neurosurg Rev 28(4):313–319

    PubMed  Article  Google Scholar 

  21. Saringer W, Nöbauer I, Haberler C, Ungersböck K (2001) Extraforaminal, thoracic, epidural cavernous haemangioma: case report with analysis of magnetic resonance imaging characteristics and review of the literature. Acta Neurochir (Wien) 143(12):1293–1297

    Article  CAS  Google Scholar 

  22. Satpathy DK, Das S, Das BS (2009) Spinal epidural cavernous hemangioma with myelopathy: a rare lesion. Neurol India 57(1):88–90

    PubMed  Article  CAS  Google Scholar 

  23. Shapiro GS, Millett PJ, DiCarlo EF, Mintz DN, Gamache FW, Rawlins BA (2001) Spinal epidural hemangioma related to pregnancy. Skeletal Radiol 30(5):290–294

    PubMed  Article  CAS  Google Scholar 

  24. Sohn MJ, Lee DJ, Jeon SR, Khang SK (2009) Spinal radiosurgical treatment for thoracic epidural cavernous hemangioma presenting as radiculomyelopathy: technical case report. Neurosurgery 64(6):E1202–E1203

    PubMed  Article  Google Scholar 

  25. Talacchi A, Spinnato S, Alessandrini F, Iuzzolino P, Bricolo A (1999) Radiologic and surgical aspects of pure spinal epidural cavernous angiomas. Report on 5 cases and review of the literature. Surg Neurol 52(2):198–203

    PubMed  Article  CAS  Google Scholar 

  26. Tekin T, Bayrakli F, Simsek H, Colak A, Kutlay M, Demircan MN (2008) Lumbar epidural capillary hemangioma presenting as lumbar disc herniation disease: case report. Spine (Phila Pa 1976) 33(21):E795–E797

    Article  Google Scholar 

  27. Zhong W, Chen H, Huang S, You C (2011) Cervical en-plaque epidural meningioma. Neurol India 59(1):132–134

    PubMed  Article  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, West China Hospital, Sichuan University, No 37, Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China

    Weiying Zhong, Siqing Huang, Haifeng Chen, Hong Sun, Bowen Cai, Yi Liu & Chao You

Authors
  1. Weiying Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Siqing Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haifeng Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hong Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bowen Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yi Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chao You
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chao You.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Zhong, W., Huang, S., Chen, H. et al. Pure spinal epidural cavernous hemangioma. Acta Neurochir 154, 739–745 (2012). https://doi.org/10.1007/s00701-012-1295-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-012-1295-3

Keywords

  • Cavernous
  • Hemangioma
  • Epidural
  • Treatment