Lumbar Vertebral Hemangioma with Extradural Extension, Causing Neurogenic Claudication: A Case Report
-
Morteza Faghih Jouibari
,
Alireza Khoshnevisan
,
Seyed Mohammad Ghodsi
,
Farideh Nejat
,
Soheil Naderi
,
Sina Abdollahzadeh
Abstract
The authors present a rare case of lumbar vertebral hemangioma extending to the epidural space with a bisected appearance and impinging on thecal sac. This 52-year-old lady presented with one year history of low back pain and bilateral leg radiation. Plain radiography showed vertical linear streaks at L2 vertebral body and axial computed tomography (CT) scan revealed small "polka dot" appearance within the vertebral body. Magnetic resonance imaging (MRI) showed low signal intensity on T1-weighted images in L2 vertebral body which was not characteristic for hemangioma. The patient underwent an L2 laminectomy, spinal canal decompression and posterior spinal instrumentation. This study indicates that lumbar vertebral hemangioma can extend to the epidural space and cause neurologic symptoms. Magnetic resonance imaging may not show diagnostic features, especially in active lesions and plain radiography and CT scan may be helpful.
Feider HK, Yuille DL. An epidural cavernous hemangioma of the spine. AJNR Am J Neuroradiol 1991;12(2):243-4.
Healy M, Herz DA, Pearl L. Spinal hemangiomas. Neurosurgery 1983;13(6):689-91.
Nguyen JP, Djindjian M, Gaston A, Gherardi R, Benhaiem N, Caron JP, Poirier J. Vertebral hemangiomas presenting with neurologic symptoms. Surg Neurol 1987;27(4):391-7.
Pastushyn AI, Slin'ko EI, Mirzoyeva GM. Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol 1998;50(6):535-47.
Dagi TF, Schmidek HH. Vascular tumors of the spine. In: Sundaresan N, Schmidek HH, Schiller AL, editors. Tumors of the Spine: Diagnosis and Clinical Management. Philadelphia: WB Saunders; 1990. p. 181-91.
Reizine D, Laredo JD, Riche MC. Vertebral hemangiomas. In: Jeanmart L, editor. Radiology of the Spine: Tumors. Berlin: Springer-Verlag; 1986. p. 73-80.
Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebralhemangiomas. J Neurosurg 1993;78(1):36-45.
Ahn H, Jhaveri S, Yee A, Finkelstein J. Lumbar vertebral hemangioma causing cauda equina syndrome: a case report. Spine (Phila Pa 1976) 2005;30(21):E662-4.
Chen HI, Heuer GG, Zaghloul K, Simon SL, Weigele JB, Grady MS. Lumbar vertebral hemangioma presenting with the acute onset of neurological symptoms. Case report. J Neurosurg Spine 2007;7(1):80-5.
. Laredo JD, Reizine D, Bard M, Merland JJ. Vertebral hemangiomas: radiologic evaluation. Radiology 1986;161(1):183-9.
Ross JS, Masaryk TJ, Modic MT, Carter JR, Mapstone T, Dengel FH. Vertebral hemangiomas: MR imaging. Radiology 1987;165(1):165-9.
Laredo JD, Assouline E, Gelbert F, Wybier M, Merland JJ, Tubiana JM. Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology 1990;177(2):467-72.
| Files | ||
| Issue | Vol 49, No 10 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| Lumbar vertebral hemangioma Extradural extension Neurogenic claudication | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
