Spinal capillary hemangiomas: Two cases reports and review of the literature

Abstract

Hemangiomas have rarely been found in the spinal cord. A few cases of spinal capillary hemangioma have been reported since 1987. The authors reported the two cases of capillary hemangioma including the tumor at conus medullaris and the another mimicked von Hippel-Lindau disease. A 15-year-old man was presented with coccydynia and left leg pain. A magnetic resonance imaging (MRI) revealed an intradural extramedullary enhancing mass at conus medullaris. Another case, a 31-year-old man was presented with a history of familial history of brain tumor, retinal hemangioma both eyes, multiple pancreatic cyst and syringobulbia with syringohydromyelia. On MRI, a well-circumscribed intramedullary nodule was detected at C5-6 level and multiple subpial nodule along cervicothoracic spinal cord. All patients underwent surgery, and the histological diagnosis confirmed capillary hemangioma. Although rare and indistinguishable from other tumors, capillary hemangioma should be in the differential diagnosis of the spinal cord tumor.

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

“…The most common region affected is thoracic (73.6%), followed by lumbosacral spine (16.9%) (1). On the other hand, SIECHs are more common in males, located in the thoracic-lumbar region and commonly affect patients aged 40-60 years (3,4). Thus, the current case is consistent with the previous literature.…”

“…SALs are infrequent and only account for 0.04-1.2% of all spinal tumors and 2-3% of epidural spinal tumors (2,9). The incidence of spinal capillary hemangiomas is still unknown, as this tumor is often found in vertebral body, while only <70 cases of intradural extramedullary lesions have been described (4). Both types of tumor are rare and the pathogenesis of these tumors is poorly understood.…”

“…Notably, because 23.8% cases of SALs coexist with vertebral hemangioma (2,12) and the pathology and imaging features of spinal infiltrating angiolipomas with bone involvement are similar to those of aggressive vertebral hemangiomas, it has been questioned whether they represent two distinct entities (6). The classifications of spinal capillary hemangioma type based on 64 patients were as follows: Pediatric (5%), epidural (8%), intradural extramedullary (70%), intramedullary (14%) and hemangiomatosis (3%) (4). In the present case, SAL was classified as the non-infiltrating type due to its clear demarcation from the dura mater and surrounding tissues, while the capillary hemangioma belongs to the intradural extramedullary type.…”

“…Gross-total resection via laminectomy and durotomy is the primary treatment option for SALs and SIECHs (2,4,6,16). Total removal of infiltrating SALs is impossible in certain cases; however prognosis seems not to differ significantly from completely resected non-infiltrating tumors (20).…”

“…In total, ~200 SAL cases of have been reported in the literature (2). Spinal intradural extramedullary capillary hemangiomas (SIECHs) are more uncommon (3), and to date, only 64 cases of SIECHs have been documented in the literature (4). The oncogenesis of these two tumor types is still unclear, but they may both arise from abnormal primitive pluripotent mesenchymal cells (4,5).…”