Spinal cord compression caused by thoracic vertebral hemangioma involving only the posterior elements of two contiguous vertebrae

Yung, Babington C. K.; Loke, Tkl; Yuen, Nancy; Chan, C. C.

doi:10.1007/s002560050359

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…Vertebral height was normal in 15 cases (72 %; cases 1, 3) [5,6,20,43,45,49,51,53,54,55,57]. In 2 cases (4 %) there was loss of anterior vertebral height of approximately 33 % (case 2) [6].…”

Section: 52]mentioning

confidence: 87%

“…In all of these cases, lesions were hypointense relative to spinal cord on T1WI (cases 1-3) [3,6,20,51,53,57]. Five of these lesions contained signal voids (20 %; case 1) [6,53,57].…”

Section: 52]mentioning

confidence: 91%

“…Twelve films showed erosion of a pedicle [2,3,14,23,28,30,41,44,57] and 4 showed abnormal vertebral body texture suggestive of metastasis (20 %; case 2) [30,44,46]. Eight affected vertebral bodies showed significant loss of height (10%) [2,3,6,14,32,36,42].…”

Section: Literature Reviewmentioning

confidence: 95%

“…In 2 cases there was a cortical break (8%; case 2) [53]. In 14 cases the integrity of the cortex was not described (56 %) [3,5,38,45,49,51,54,55,57,59].…”

Section: 55 57]mentioning

confidence: 99%

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Imaging of compressive vertebral haemangiomas

et al. 2000

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Compressive vertebral haemangiomas (VHs) are rare. Correct preoperative diagnosis is useful both for operative planning (since compressive VHs are extremely vascular lesions) and to allow preoperative embolisation. Numerous radiological signs for VHs have been described, but compressive VHs frequently have atypical features. In particular, magnetic resonance features are not well established. We present imaging features in three cases of compressive VH and review the imaging findings in an additional 106 previously published cases. Findings were typical in 52 of 80 plain film (65%), 33 of 41 computed tomography (80%) and 13 of 25 magnetic resonance examinations (52%). The prevalence of previously described imaging features is reported. Awareness of the range of magnetic resonance features is important since this is frequently the initial investigation in patients presenting with symptoms of neural compression. Since computed tomography is typical in 80% of cases, this is a useful confirmatory test if magnetic resonance features are suspicious but not diagnostic of compressive VH.

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Section: 52]mentioning

confidence: 87%

“…In all of these cases, lesions were hypointense relative to spinal cord on T1WI (cases 1-3) [3,6,20,51,53,57]. Five of these lesions contained signal voids (20 %; case 1) [6,53,57].…”

Section: 52]mentioning

confidence: 91%

Section: Literature Reviewmentioning

confidence: 95%

“…In 2 cases there was a cortical break (8%; case 2) [53]. In 14 cases the integrity of the cortex was not described (56 %) [3,5,38,45,49,51,54,55,57,59].…”

Section: 55 57]mentioning

confidence: 99%

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Imaging of compressive vertebral haemangiomas

et al. 2000

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“…52 In the 1970s it was suggested that angiography could be used not only to confirm the diagnosis but also to perform endovascular embolization of the feeding arteries in order to reduce vascularity of the tumor and decrease blood loss during surgery. 8,19,22,37,50,53,59,73 The benefits of embolization were confirmed in a systematic review that included 51 patients with aggressive vertebral hemangiomas. This study found that in the group that received preoperative embolization, blood loss was significantly less than in the group that did not (980 vs 1629 ml, respectively).…”

Section: Endovascular Embolizationmentioning

confidence: 93%

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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Vertebral haemangioma in a Roman period skeleton from the Dakhleh Oasis, Egypt

Molto

Chhem

Maxwell

et al. 2020

Intl J of Osteoarchaeology

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A 50‐ to 65‐year‐old female, from the Roman period Kellis 2 (K2) cemetery in the Dakhleh Oasis, Egypt, shows macroscopic and imaging evidence of a vertebral haemangioma (VH). The centrum of the 12th thoracic vertebrae has an expanded and lysed cortex and thickened vertical trabeculae—producing the pathognomonic “corduroy” radiological sign. Additionally, the first lumbar vertebrae shows early changes of haemangioma that are not obvious macroscopically but clear on the X‐ray and the microcomputed tomography (μCT) imaging. VHs are relatively common (>10%) benign vascular tumours in extant adult populations. Its rarity in antiquity can be explained by the fact that in most archaeological samples, haemangiomas would not be macroscopically visible because the destruction and expansion of the cortex only occurs in advanced cases (usually in older individuals). In archaeological populations, older individuals (60+), though present, are much less common, and hence, the prevalence of VHs would be much lower than that reported in modern clinical samples. We posit that in order to determine the approximate prevalence of VHs in antiquity, a systematic radiographic study of an entire adult archaeological population sample is required. A caveat to this problem is that radiological diagnosis is difficult unless at least one third of the centrum is involved, and the classic radiological signs are manifested. A review of case studies suggest that X‐rays from T4 to L4 would include ~95% of the potential cases of VHs, and if a portable μCT unit can be developed, the natural history of VHs will be better established.

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Spinal cord compression caused by thoracic vertebral hemangioma involving only the posterior elements of two contiguous vertebrae

Cited by 15 publications

References 7 publications

Imaging of compressive vertebral haemangiomas

Imaging of compressive vertebral haemangiomas

Surgical treatment of aggressive vertebral hemangiomas

Vertebral haemangioma in a Roman period skeleton from the Dakhleh Oasis, Egypt

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