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Abstract：
UNASSIGNED: Spinal epidural cavernous hemangiomas are a rare occurrence. This particular case is made even more distinctive by the fact that the lesion mimicked a dumbbell-shaped neuroma. Moreover, it had a very unique localization (wholly epidural, at cervical-thoracic -C7-D1- level). The importance of this case is linked not only to its remarkable rarity, but also to the diagnostic avenues explored. The surgery was carried out by Prof. Riccardo Caruso, Head of the Neurosurgical Department of the Military Hospital of Rome and Professor of Neurosurgery of Sapienza University of Rome, assisted by Dr. Luigi Marrocco, Senior Neurosurgeon of the Military Hospital of Rome. Postsurgical recovery was managed by Dr. Venceslao Wierzbicki, Senior Neurosurgeon of the Military Hospital of Rome.
METHODS: In 2020, a 71 year-old man, suffering from intense pain in the left scapular region and in the ulnar area of the left forearm, underwent surgery for the removal of a spinal epidural cavernous hemangioma involving the left C7-D1 foramen. Prior to surgery, the lesion had been misdiagnosed as a neuroma by a radiologist.
UNASSIGNED: In the Literature there are other, rare cases of hemangiomas partly located in the spinal canal, and partly located intra and extra foramen. In the case here presented, differential diagnosis as well as a potential Schwannoma, suggested by the dumbbell shape of the lesion, should have considered also the possibility of a meningioma. Two teams of radiologists examined the images, the radiologists of our team, Dr. Valentina Martines and Dr. Emanuele Piccione, thanks to a close inspection of the features of the lesion, postulated the extra-dural position. Other aspects of the scans were then analyzed to help guide future diagnosis of similar lesions.
CONCLUSIONS: With a spinal tumor affecting the foramen, a close examination of the images allows for accurate presurgical differential diagnosis, differentiating between the more frequent neuroma and other rarer tumors, such as a hemangioma.
METHODS: In 2020, a 71 year-old man, suffering from intense pain in the left scapular region and in the ulnar area of the left forearm, underwent surgery for the removal of a spinal epidural cavernous hemangioma involving the left C7-D1 foramen. Prior to surgery, the lesion had been misdiagnosed as a neuroma by a radiologist.
UNASSIGNED: In the Literature there are other, rare cases of hemangiomas partly located in the spinal canal, and partly located intra and extra foramen. In the case here presented, differential diagnosis as well as a potential Schwannoma, suggested by the dumbbell shape of the lesion, should have considered also the possibility of a meningioma. Two teams of radiologists examined the images, the radiologists of our team, Dr. Valentina Martines and Dr. Emanuele Piccione, thanks to a close inspection of the features of the lesion, postulated the extra-dural position. Other aspects of the scans were then analyzed to help guide future diagnosis of similar lesions.
CONCLUSIONS: With a spinal tumor affecting the foramen, a close examination of the images allows for accurate presurgical differential diagnosis, differentiating between the more frequent neuroma and other rarer tumors, such as a hemangioma.
摘要：
■脊髓硬膜外海绵状血管瘤是罕见的。病变模仿哑铃形神经瘤的事实使这种特殊情况变得更加独特。此外，它有一个非常独特的定位(完全硬膜外，在颈胸-C7-D1-水平）。这起案件的重要性不仅与其异常罕见有关，而且还探索了诊断途径。手术由教授进行。里卡多·卡鲁索,罗马军队医院神经外科主任,罗马萨皮恩扎大学神经外科教授,在LuigiMarrocco博士的协助下,罗马军队医院高级神经外科医生。术后恢复由VenceslaoWierzbicki医生管理，罗马军队医院高级神经外科医生。
方法：2020年，一名71岁的男子，患有左肩胛骨区域和左前臂尺骨区域的剧烈疼痛，接受手术切除累及左侧C7-D1孔的脊髓硬膜外海绵状血管瘤.手术前,放射科医生误诊为神经瘤。
■在文献中还有其他，部分位于椎管内的血管瘤的罕见病例，部分位于孔内外。在这里介绍的案例中，鉴别诊断以及潜在的神经鞘瘤，由病变的哑铃形暗示，还应该考虑脑膜瘤的可能性。两队放射科医生检查了这些图像，我们团队的放射科医生,ValentinaMartines博士和EmanuelePiccione博士,多亏了对病变特征的仔细检查，假设硬脑膜外位置。然后分析了扫描的其他方面，以帮助指导将来对类似病变的诊断。
结论：脊柱肿瘤影响孔，仔细检查图像可以进行准确的术前鉴别诊断，区分更常见的神经瘤和其他罕见的肿瘤，比如血管瘤.
方法：2020年，一名71岁的男子，患有左肩胛骨区域和左前臂尺骨区域的剧烈疼痛，接受手术切除累及左侧C7-D1孔的脊髓硬膜外海绵状血管瘤.手术前,放射科医生误诊为神经瘤。
■在文献中还有其他，部分位于椎管内的血管瘤的罕见病例，部分位于孔内外。在这里介绍的案例中，鉴别诊断以及潜在的神经鞘瘤，由病变的哑铃形暗示，还应该考虑脑膜瘤的可能性。两队放射科医生检查了这些图像，我们团队的放射科医生,ValentinaMartines博士和EmanuelePiccione博士,多亏了对病变特征的仔细检查，假设硬脑膜外位置。然后分析了扫描的其他方面，以帮助指导将来对类似病变的诊断。
结论：脊柱肿瘤影响孔，仔细检查图像可以进行准确的术前鉴别诊断，区分更常见的神经瘤和其他罕见的肿瘤，比如血管瘤.
