Case Study of a Spinal Epidural Capillary Hemangioma: A 4-Year Postoperative Follow-Up

Abstract

Study Design Case study. Objectives We report the case of a 58-year-old Caucasian man, who presented with a 4-month history of increasing low back pain and gait difficulty. Objective neurologic examination revealed a severe paraparetic symptomatology without any sphincter involvement. Methods Spinal magnetic resonance imaging (MRI) showed an extradural mass formation situated dorsally at the level of thoracic vertebrae T2 to T4. Results A laminectomy was performed with total removal of the mass; histology suggested a highly vascularized lesion with lobular architecture, which seems a very rare case, compatible with a capillary hemangioma. Conclusions A careful follow-up for the next 4 years, including control MRIs every postoperative year, showed a very good neurologic condition of the patient and no recurrence on imaging findings.

Epidural capillary hemangioma: A review of the literature

“…In contrast, epidural hemangiomas present clinically with progressive myelopathy and no signs of acute or chronic bleeding. All reported cases have presented with back pain, radicular pain, or chronic myelopathy due to the compression of the spinal cord by the masses [2][3][4][5]. The presenting symptoms of our case were restlessness and the inability to walk.…”

“…All of the published cases occurred in adults over the age Gupta et al (1996) [8] of 40 years. Five of these hemangiomas were in the thoracic region [2][3][4][6][7][8], and one was in the lumbar region [5]. The lengths of the masses in these cases extended to a maximum of two or three vertebral segments.…”

“…The occurrence of epidural capillary hemangiomas is exceedingly rare. Only seven cases have been reported in the English literature, and all of these cases have occurred in adulthood [2][3][4][5][6][7][8].…”

A Rare Case of Dumbbell-shaped Spinal Epidural Capillary Hemangioma

“…To the best of our knowledge, only nine cases in the English literature have been described. [2][3][4][5][6][7][8][9] Eight of these cases involved thoracic spinal levels and one case involved a lumbar level. 8 Of these, four cases presented with an extraforaminal extension causing a dumbbell-shaped appearance in spinal MRI studies.…”

“…3 Cavernous hemangiomas present with an acute symptomatology related to intratumoral bleeding. 7,14 Complete surgical removal is the treatment of choice for epidural capillary hemangioma. 15,16 Recurrences have not been described in the literature and in most cases, as in our case, the pain relieved significantly, and sensory and motor deficits were improved from preoperative medical research council grade II to grade IV postoperatively.…”