PDF(Pubmed)
Abstract：
BACKGROUND: Pure epidural spinal cavernous hemangiomas are rare, benign vascular tumors that account for approximately 4% of all spinal epidural tumors. Due to their dumbbell shape and propensity for foraminal invasion, they are often misdiagnosed and inadequately treated. We present a case of a 58-year-old male with extra-osseous cavernous hemangioma to better aid in diagnosis and management of these lesions.
METHODS: A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. He underwent resection with histopathologic exam revealing a pure epidural cavernous hemangioma.
CONCLUSIONS: Spinal epidural cavernous hemangiomas are exceedingly rare lesions that are often misdiagnosed as nerve sheath tumors and meningiomas. Common features include chronic pain and myelopathy as well as T1 isodensity, T2 hyperintensity, and homogenous enhancement. Uniquely, they present as a lobulated, spindled shape with tapered ends in the dorsal epidural space. Both gross and subtotal resection result in favorable neurologic outcomes.
METHODS: A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. He underwent resection with histopathologic exam revealing a pure epidural cavernous hemangioma.
CONCLUSIONS: Spinal epidural cavernous hemangiomas are exceedingly rare lesions that are often misdiagnosed as nerve sheath tumors and meningiomas. Common features include chronic pain and myelopathy as well as T1 isodensity, T2 hyperintensity, and homogenous enhancement. Uniquely, they present as a lobulated, spindled shape with tapered ends in the dorsal epidural space. Both gross and subtotal resection result in favorable neurologic outcomes.
摘要：
背景：单纯硬膜外脊髓海绵状血管瘤是罕见的，良性血管肿瘤，约占所有脊髓硬膜外肿瘤的4%。由于它们的哑铃形和孔侵入的倾向，他们经常被误诊和治疗不当。我们介绍了一例58岁的男性骨外海绵状血管瘤，以更好地帮助诊断和治疗这些病变。
方法：一名58岁男性出现慢性下背痛，进行性下肢无力,T10感官水平，下肢本体感觉缺失，反射亢进,和大便失禁.成像显示T7-T10同质背侧硬膜外肿块引起索信号变化。他接受了组织病理学检查的切除术，发现单纯的硬膜外海绵状血管瘤。
结论：脊髓硬膜外海绵状血管瘤是极为罕见的病变，常被误诊为神经鞘瘤和脑膜瘤。常见特征包括慢性疼痛和脊髓病以及T1等密度，T2高强度，和同质增强。独特的,它们呈现为分叶的，纺锤形，在硬膜外背侧间隙有锥形末端。总切除和次全切除均可产生良好的神经系统结局。
方法：一名58岁男性出现慢性下背痛，进行性下肢无力,T10感官水平，下肢本体感觉缺失，反射亢进,和大便失禁.成像显示T7-T10同质背侧硬膜外肿块引起索信号变化。他接受了组织病理学检查的切除术，发现单纯的硬膜外海绵状血管瘤。
结论：脊髓硬膜外海绵状血管瘤是极为罕见的病变，常被误诊为神经鞘瘤和脑膜瘤。常见特征包括慢性疼痛和脊髓病以及T1等密度，T2高强度，和同质增强。独特的,它们呈现为分叶的，纺锤形，在硬膜外背侧间隙有锥形末端。总切除和次全切除均可产生良好的神经系统结局。
