Epidural capillary hemangioma: A review of the literature

Gençpınar, Pınar; Açıkbaş, Sabri Cem; Nur, Banu; Karaali̇, Kami̇l; Arslan, Murat; Gurer, Elif Inanc; Duman, Özgür; Haspolat, Şenay

doi:10.1016/j.clineuro.2014.08.026

Cited by 20 publications

(26 citation statements)

References 10 publications

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“…Their histopathological characteristics include thin irregular capillary-sized vessels captured in fibrous low attenuating, lobular architecture, and the presence of a continuous basal lamina coating. [ 5 6 ] Capillary hemangiomas are usually found in the skin and soft tissues. [ 5 ] Pure epidural hemangiomas are rare; so far, only ten cases have been reported in the Western literature.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] They are histologically classified as cavernous, capillary, venous, or arteriovenous hemangiomas based on the pattern of their vascular channels. [ 2 5 ] The majority of spinal hemangiomas reported in the literature are of the cavernous type. [ 7 ] Spinal epidural capillary hemangiomas are the most uncommon tumors typically found at other sites (e.g., skin, soft tissues, or bones).…”

Section: Introductionmentioning

confidence: 99%

“…[ 7 ] Spinal epidural capillary hemangiomas are the most uncommon tumors typically found at other sites (e.g., skin, soft tissues, or bones). [ 5 ] Here, we report a patient who presented with a pure epidural capillary hemangioma in the thoracic spine.…”

Section: Introductionmentioning

confidence: 99%

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Atypical spinal epidural capillary hemangioma: Case report

Brasil¹,

Rohrmoser²,

Gago³

et al. 2018

Surg Neurol Int

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Background:Hemangiomas are benign vascular malformations that can involve the spine. Pure epidural hemangiomas are rare and represent only 4% of all epidural lesions. Most hemangiomas are of the cavernous type; the capillary variant is atypical, and only ten cases have been reported in the literature.Case Description:A 69-year-old female presented with nonspecific dorsal pain. Magnetic resonance imaging (MRI) showed a spinal epidural tumor at the T9-T10 level. Following a T9-T11 laminectomy, the lesion was completely resected en bloc. Histopathologic analysis showed a pure epidural capillary hemangioma with adipose tissue mesenchyma.Conclusions:Although epidural capillary hemangiomas are extremely rare, they should be considered among the differential diagnoses of extradural, extramedullary spinal lesions. Further, they must be differentiated from other more common lesions such as meningiomas and schwannomas. The recommended surgical management is en bloc gross total excision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Atypical spinal epidural capillary hemangioma: Case report

Brasil¹,

Rohrmoser²,

Gago³

et al. 2018

Surg Neurol Int

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“…These lesions tend to display iso-signal or low signal on T1WI and high signal on T2WI, with homogeneous enhancement after injection of contrast material, most of which are located in the posterior epidural space and present with myelopathy [19,20]. In previous reported cases with specified MRI findings (n = 7), six of which showed isosignal on T1WI and high signal on T2WI; additionally, four out of five with contrast material injection demonstrated homogeneous signal enhancement.…”

Section: Discussionmentioning

confidence: 99%

Spinal dumbbell-shaped epidural cavernous hemangioma (CM): report of nine surgical cases and literature review

Zhang

Yang

et al. 2018

Chin Neurosurg Jl

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Background: Spinal dumbbell-shaped epidural cavernous malformation (CM) is a rare, hypervascular entity frequently misdiagnosed for other lesions, leading to unexpected intraoperative bleeding and suboptimal resection. Our study aims to elucidate the demographics, management strategy, and outcome of this vascular disease. Methods: Retrospective review of patients seen in Beijing Tiantan Hospital with symptomatic dumbbell-shaped epidural CM from 2008 to 2013. All lesions were pathologically confirmed after resection. The clinical manifestations, radiographic features, and treatment modalities of these cases were analyzed. Results: We included 9 consecutive patients. Average age was 58 ± 12 years (range: 34-79 years), with 66.7% male. Locations of the CMs were: thoracic (n = 7, 77.8%), cervical (n = 1, 11.1%), and cervicothoracic junction (n = 1, 11.1%). Only one case presented with acute manifestations while others experienced chronic progressive spinal cord symptoms. The initial clinical diagnoses were: schwannoma (n = 6, 66.7%), cavernous hemangioma (CM) (n = 1, 11. 1%), meningioma (n = 1, 11.1%), and angioma (n = 1, 11.1%). Total resection was achieved in six patients (66.7%), and partial resection in the other three patients (33.3%). Average intraoperative blood loss was 400 ± 300 ml (range: 100-1000 ml). During an average follow-up of 71 ± 21 months (range: 29-94 months), excellent outcome was achieved in seven cases (77.8%), one partially improved (11.1%), and one deteriorated (11.1%). No patients experienced recurrence of symptoms. Conclusions: Spinal dumbbell-shaped epidural CM is a benign vascular malformation that should be differentiated from other dumbbell-shaped lesions. Accurate preoperative diagnose is challenging as no specific radiographic marker has been established. Total surgical resection should be recommended.

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“…The arteriovenous malformation shows with a cluster of abnormal arteries and veins and vessel walls containing elastin, and smooth muscle (28). The characteristic features of capillary hemangioma are thin irregular capillary-sized vessels caught in low attenuating fibroses, lobular architecture and the presence of a lining of a continuous basal lamina (29). Typical histological features of CAs include large number of sinusoidal channels in collagenous tissue, sometimes with thrombosis, blood, calcification, and perivascular hemosiderin deposition (2,7,11,12).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and surgical outcomes of solitary spinal epidural cavernous angiomas

2018

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Abstract. The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre-and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively. Solitary epidural CAs generally exhibited isointensity on T1-weighted images and hyperintesity on T2-weighted images. Contrast-enhanced T1-weighted images showed homogeneous markedly enhancement. Gross total resection (GTR) was achieved in 11 cases, and subtotal resection (STR) was achieved in 1 case. During an average follow up of 35.9 months, neurological function was improved in 11 patients and in one patient, preoperative status was maintained. No patient experienced tumor recurrence. These findings suggest that CAs should be considered in the differential diagnosis of spinal epidural lesions. Early surgery is advocated to prevent irreversible neurological deficits. When aggravated by a large amount of acute hemorrhage, neurological deterioration is usually acute and prompt surgical decompression is the optimal choice. Because of the excessive vascularity of CAs, en bloc resection is recommended. In addition, a good clinical outcome after GTR can be expected, and the risk of long-term recurrence is low.

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Epidural capillary hemangioma: A review of the literature

Cited by 20 publications

References 10 publications

Atypical spinal epidural capillary hemangioma: Case report

Atypical spinal epidural capillary hemangioma: Case report

Spinal dumbbell-shaped epidural cavernous hemangioma (CM): report of nine surgical cases and literature review

Clinical characteristics and surgical outcomes of solitary spinal epidural cavernous angiomas

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