An aggressive vertebral hemangioma in pregnancy: a case report

Slimani, Ouafae; Jayi, Sofia; Alaoui, Fatimazahra Fdili; Bouguern, Hakima; Chaara, Hikmat; Fikri, Ghizlane; Rachidi, Siham Alaoui; Houssaini, N. Sqalli; Himmich, Mariam; Melhouf, Moulay Abdelilah

doi:10.1186/1752-1947-8-207

Cited by 21 publications

(16 citation statements)

References 11 publications

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“…12,48,51,59,61,64,67 Aggressive vertebral hemangiomas are also more common in adults but have been reported in children as well. 11,18,44,54 It is generally agreed that surgical intervention is warranted when hemangiomas cause pain or neurological symptoms, however the optimal treatment strategy is controversial.…”

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confidence: 99%

Surgical treatment of aggressive vertebral hemangiomas

Vasudeva

John

Groff

2016

FOC

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OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of “hemangioma” between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3–65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the patient who underwent en bloc resection who continued to have back pain. CONCLUSIONS Gross-total resection or subtotal resection in combination with vertebroplasty or adjuvant radiation therapy to treat residual tumor seems sufficient in the treatment of aggressive vertebral hemangiomas. En bloc resection appears to provide a similar oncological benefit, but it carries higher morbidity to the patient.

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confidence: 99%

Surgical treatment of aggressive vertebral hemangiomas

Vasudeva

John

Groff

2016

FOC

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“…For spine tumors in pregnancy, a recent report found that giant cell tumors, hemangiomas, and schwannomas were the most frequent tumor types [10]. There have been case reports describing these tumors along with spinal meningiomas and ependymomas [8,[11][12][13][14][15]. Spinal ependymomas are rare benign, slow-growing tumors that can present with back pain and neurologic changes depending on their location within the cord [2,15,16].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and rehabilitation of a pregnant woman with spinal cord disorder due to spinal cord tumor

Bitterman

Donovan

Lam

2019

Spinal Cord Ser Cases

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Introduction Spinal cord tumors are a rare cause of spinal cord disorder (SCD). Early diagnosis can be challenging, especially in patient populations with other potential etiologies for back pain, such as pregnant women. Case presentation A 28-year-old female presented at 8 weeks gestation with thoracic back pain initially diagnosed as gestational low back pain. Her symptoms progressed to lower extremity weakness. After diagnosis and resection of a spinal cord ependymoma, we collaborated with the inpatient interdisciplinary team to devise a rehabilitation program focused on minimizing pregnancy-related complications and optimizing care of a newborn in the setting of a new paraplegia. Discussion Providers should not assume all pregnant women with low back pain have gestational back pain, as it can be due to more insidious causes. The rehabilitation course for women who develop an SCD during gestation should be carefully tailored toward their pre-and post-natal care and with the education of how the disorder can affect pregnancy and parenting.

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“…Hemangioma is usually asymptomatic and incidentally discovered (4). About 1% of cases may be symptomatic (aggressive hemangiomas) (1,8), which present with merely pain or alongside neurological involvement. They are commonly found in the thoracic region and become symptomatic followed by mild trauma or at the end of pregnancy (third trimester of pregnancy) or even spontaneously (2,6).…”

Section: Discussionmentioning

confidence: 99%

“…Its appearance is characterized by honey comb, corduroy in the lateral radiography or CT sagittal and coronal (1,6,8). Asymptomatic hemangiomas usually involve the vertebral body partly with posterior elements not involved.…”

Section: Discussionmentioning

confidence: 99%

Aggressive Hemangioma of the Thoracic Spine with Cord Compression: A Case Report

Zaraei¹,

Vahar²,

Firoozabadi³

et al. 2017

J Orthop Spine Trauma

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Vertebral hemangiomas are common neoplasms of the spine and usually considered benign. They are usually asymptomatic and incidentally detected. A rare subset of them, referred to as aggressive hemangiomas, can be symptomatic presented with pain and neurological symptoms. The current study presented a case of a 27-year-old female with a four-month history of pain in thoracic spine and neurological involvement of the lower limbs for three weeks before the visit. Further investigations with computed tomography (CT) scan and magnetic resonance imaging (MRI) showed aggressive hemangioma in T4 vertebra with cord compression. The patient underwent laminectomy of T4, posterior fixation of T2-T6 and vertebroplasty. Final pathologic diagnosis after surgery confirmed the diagnosis of vertebral hemangioma. One month after surgery, the patient's motor symptoms and three months later, sensory symptoms were resolved.

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An aggressive vertebral hemangioma in pregnancy: a case report

Cited by 21 publications

References 11 publications

Surgical treatment of aggressive vertebral hemangiomas

Surgical treatment of aggressive vertebral hemangiomas

Diagnosis and rehabilitation of a pregnant woman with spinal cord disorder due to spinal cord tumor

Aggressive Hemangioma of the Thoracic Spine with Cord Compression: A Case Report

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