椎体血管瘤(VHs)是从血管的内胚层发展而来的良性血管肿瘤,尽管他们的确切发病机制知之甚少。大多数血管瘤很小,大约三分之一是倍数,这些血管瘤中的一小部分会引起症状。更罕见的是侵略性的退伍军人,包括少量的所有VH,并与扩张和骨外伸入椎旁和硬膜外间隙有关。侵袭性VHs的管理涉及术前栓塞,脊柱手术,和重建。疼痛管理,身体康复,密切的神经系统随访对于接近完全恢复至关重要。侵袭性VHs最常见于胸部,但很少涉及大量椎骨。皮肤血管瘤,当与VHs一起看到时,通常是异色的。我们提出了一个罕见且具有挑战性的压缩性脊髓病和大皮肤血管瘤或“紫色肩”的病例,在一名年轻男性的考试中发现的。他被发现有一个广泛的VH延伸到13个椎骨水平(C7到D12),皮肤病变的非同色性。彻底的体检和评估以及及时的手术治疗是治疗和预防永久性神经功能缺损的基石。
Vertebral hemangiomas (VHs) are benign vascular tumors that develop from the endoderm of blood vessels, although their exact pathogenesis is poorly understood. Most hemangiomas are small, about a third are multiple in number, and a very small number of these hemangiomas cause symptoms. Even more rare are aggressive VHs, which comprise a small number of all VHs, and are associated with expansion and extraosseous extension into the paraspinal and epidural spaces. Management of aggressive VHs involve pre-op embolization, spinal surgery, and reconstruction. Pain management, physical rehabilitation, and close neurological follow-up are imperative to near-total recovery. Aggressive VHs are most commonly seen in the thoracic region but may rarely involve a large number of vertebrae. Cutaneous hemangiomas, when seen along with VHs, are often metameric. We present a rare and challenging case of compressive myelopathy and a large cutaneous hemangioma or a \"purple shoulder\", found during an exam in a young male. He was found to have an extensive VH extending through 13 vertebral levels (C7 to D12), non-metameric to the cutaneous lesion. A thorough physical examination and evaluation along with prompt surgical treatment were the cornerstone of treatment and prevention of permanent neurological deficits.