Aggressive vertebral hemangioma as a rare cause of myelopathy

Sarı, Hidayet; Uludağ, Murat; Akarırmak, Ülkü; Örnek, Nurettin İrem; Gün, Kerem; Gülşen, Fatih

doi:10.3233/bmr-130425

Cited by 3 publications

(10 citation statements)

References 12 publications

(24 reference statements)

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“…However, in rare cases, they may be aggressive, with neurological deficit due to spinal cord compression. 1,2,[5][6][7][8] The evolutionary form of the present case demonstrates aggressive and nonconcomitant diffuse lesions in a symp-tomatic male patient, with the appearance of new hemangiomas during follow-up, which were not subject to conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Na coluna, a localização torácica é mais comum nas regiões média e inferior, seguidas da região lombar, ocorrendo mais raramente na região cervical. 1,2 O tratamento do hemangioma intraósseo depende dos sintomas em cada região afetada. 4 Fig.…”

Section: Discussionunclassified

“…Contudo, em raros casos, heman-giomas podem se apresentar agressivos, com déficit neurológico decorrente de compressão medular. 1,2,[5][6][7][8] A forma evolutiva do presente caso demonstra lesões difusas, em paciente masculino, sintomáticas, agressivas e não concomitantes, com surgimento de novos hemangiomas durante o seguimento, não passíveis de tratamento conservador.…”

Section: Discussionunclassified

“…In the spine, thoracic localization is more common in the middle and lower regions, followed by the lumbar region, occurring more rarely in the cervical region. 1 2…”

Section: Discussionmentioning

confidence: 99%

“…However, in rare cases, they may be aggressive, with neurological deficit due to spinal cord compression. 1 2 5 6 7 8…”

Section: Discussionmentioning

confidence: 99%

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Hemangioma intraósseo difuso agressivo: Relato de caso

Alves

Ziegler

Dannebrock

et al. 2021

Rev Bras Ortop (Sao Paulo)

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ResumoO hemangioma vertebral, um tumor vascular benigno, geralmente é assintomático e descoberto incidentalmente em exames de imagem. Quando sintomático, a apresentação mais frequente ocorre sob a forma de dorsalgia vaga de início insidioso e, em raros casos, pode estar associado a compressão radicular ou medular, causando déficit sensitivo e motor. Os autores relatam o caso de um homem de 33 anos, previamente hígido, com diagnósticos de hemangioma na coluna torácica em múltiplos níveis, no esterno, na escápula e nos arcos costais; todas as lesões eram sintomáticas e houve necessidade de intervenção cirúrgica, sendo que uma das lesões ao nível da coluna torácica evoluiu com compressão medular e déficit neurológico agudo, com necessidade de intervenção cirúrgica de urgência. Os hemangiomas intraósseos representam < 1% de todos os tumores ósseos, e a apresentação multifocal no esqueleto axial e apendicular apresenta poucos relatos. Na revisão bibliográfica, não foi encontrado outro caso de hemangioma intraósseo multifocal agressivo com tal apresentação, inclusive com sintomas neurológicos associados em um mesmo caso.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

“…In the spine, thoracic localization is more common in the middle and lower regions, followed by the lumbar region, occurring more rarely in the cervical region. 1 2…”

Section: Discussionmentioning

confidence: 99%

“…However, in rare cases, they may be aggressive, with neurological deficit due to spinal cord compression. 1 2 5 6 7 8…”

Section: Discussionmentioning

confidence: 99%

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Hemangioma intraósseo difuso agressivo: Relato de caso

Alves

Ziegler

Dannebrock

et al. 2021

Rev Bras Ortop (Sao Paulo)

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Atypical Radiographic Features of Aggressive Vertebral Hemangiomas

Wang

Zhang

Yang

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Vertebral hemangioma (VH) is one of the most common benign spinal tumors and can be aggressive in some cases. While most aggressive VHs have typical radiographic features, including vertical striations, a honeycomb appearance, and/or a “polka-dot sign” in computed tomography (CT) scans, cases with atypical features might complicate diagnosis. This study aimed to determine the range and frequency of these atypical features. Methods: In this retrospective study, to identify the typical and atypical features of aggressive VH, pretreatment CT and magnetic resonance imaging (MRI) were reviewed retrospectively by 1 radiologist and 1 orthopaedic surgeon. Percutaneous biopsies were performed to confirm the VH in atypical cases. Results: A total of 95 patients with aggressive VHs were treated in our hospital from January 2005 to December 2017. Thirty-four (36%) of the lesions showed at least 1 atypical radiographic feature: 16 patients (17%) had a vertebral compression fracture, 11 patients (12%) had expansive and/or osteolytic bone destruction without a honeycomb appearance and/or “polka-dot sign”, 11 patients (12%) had obvious epidural osseous compression of the spinal cord, 12 patients (13%) had involvement of >1 segment, 9 patients (10%) had a VH centered in the pedicle and/or lamina, and 8 patients (8%) had atypical MRI signals. Forty-three patients underwent percutaneous biopsies, which had an accuracy of 86%. Conclusions: Based on radiographic analysis, aggressive VH can be classified as typical or atypical. More than one-third of aggressive VH lesions may have at least 1 atypical feature. CT-guided biopsies are indicated for these atypical cases.

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Preoperative Endovascular Embolisation of the Symptomatic Hemangioma in 7th Thoracic Vertebrae: Case Report

Sekulić

Jovanovski

Stevanović

et al. 2020

Serbian Journal of Experimental and Clinical Research

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Although, as asymptomatic, they appear in about 10- 12% of the worldwide population, vertebrae hemangiomas are symptomatic in about 0.9-1.2% of all the cases. We showed the case of the symptomatic hemangioma in the 7th thoracic vertebrae in 67 year old patient, that was successfully preoperative embolised. Magnetic resonance imaging (MRI) detected the tumor in the body of 7th vertebrae with mass effect on the anterior aspect of the spinal cord. Multidetector computed tomography (MDCT) imaging describes this tumor as hemangioma that is in the body of the 7th vertebrae and in the both pedicules. We performed selective and supraselective spinal angiography which showed pathological vascularisation of the tumor, and then the tumor was embolised. The control angiography detected the reduction of the tumor blood vessels, as a sign of the successful embolisation. Ten days after embolisation, the patient went through corporectomia of the Th7 and the stabilization of the thoracic spine was performed. Intraoperative blood transfusion in our patient was 930 mL, while expected blood transfusion during the surgical intervention without preoperative embolisation is about 1600 mL. Method of choice in conditions with neurological compressive symptoms caused by vertebral hemangioma is surgery for the decompression of the nerve structures. Embolisation of aggressive vertebral hemangioma is recommended and preoperatively performed for the intraoperative hemorrhage reduction and decreasing of intraoperative complications.

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Aggressive vertebral hemangioma as a rare cause of myelopathy

Cited by 3 publications

References 12 publications

Hemangioma intraósseo difuso agressivo: Relato de caso

Hemangioma intraósseo difuso agressivo: Relato de caso

Atypical Radiographic Features of Aggressive Vertebral Hemangiomas

Preoperative Endovascular Embolisation of the Symptomatic Hemangioma in 7th Thoracic Vertebrae: Case Report

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