Rapid Regrowth of a Capillary Hemangioma of the Thoracic Spinal Cord

Abstract

A 48-year-old man presented with a 2-week history of progressive gait disturbance. Neurological examinations showed mild weakness in his lower extremities and depreciation of deep sensation. Magnetic resonance (MR) imaging showed an intradural extramedullary enhanced lesion at the levels of the T10 and T11 vertebrae. Laminectomy of the T10 and T11 vertebrae was performed, and the vascular tumor on the spinal cord surface was completely resected. Histological analysis indicated that the lesion was a capillary hemangioma with an elevated proliferative index. Postoperatively, the patient showed rapid motor and sensory improvement. However, 6 months after the operation, MR imaging showed regrowth of the tumor although the clinical symptoms of the patient had not deteriorated. The patient has shown no tumor regrowth 9 years after the second operation. Capillary hemangiomas in the skin and soft tissues are often associated with high proliferative activity, and recurrence/regrowth is not infrequent. On the other hand, recurrence/regrowth of capillary hemangioma in the neuraxis after tumor resection has rarely been observed, even in cases of incomplete resection. The present case illustrates the treatment of recurrent capillary hemangioma of the spinal cord.

Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature

“…The lesions were in the thoracic spine in 15 of the 35 cases and in the lumbar or conus medullaris region in the remaining cases. The thoracic lesions were located between T4 and T11 vertebrae [5–7, 9–13, 16, 18, 20]. Our case, which occurred at the T2 level, appears to be the most cranial case.…”

Epidural angiolipoma with concomitant intradural extramedullary capillary hemangioma at the same spinal level: A case report

“…A number of authors have reviewed the demographic characteristics of SALs and SIECHs. SALs predominantly affect patients between 40 and 60 years (1,12), with a slight female predilection (13). The duration of symptoms before presentation may vary from a few minutes to 30 years (1).…”

Intramedullary spinal capillary hemangiomas: clinical features and surgical outcomes

“…Capillary hemangiomas in the skin or soft tissues usually grow rapidly and develop a relatively stable period after achieving a maximum size (several millimeters to centimeters) within a few weeks to months. 6,19 Whereas intramedullary spinal capillary hemangiomas may cause neurological deficits at the early stage of growth, the size of these lesions may not be their maximum at the time of the presentation of symptoms. Therefore, a small remnant may be still in a proliferative phase after resection and show regrowth in follow-up evaluations.…”