Spinal Epidural Cavernous Hemangioma: A Clinical Series of 7 Patients

Gao, Chuanping; Xu, Wenjian; Lian, Ji Qing; Duan, Feng; Liu, Hua

doi:10.1016/j.wneu.2017.12.006

Cited by 14 publications

(30 citation statements)

References 24 publications

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“…Even when complete removal is accomplished, some symptoms may persist, possibly due to scarring around the dural sac or the involved nerve root but this does not necessarily indicate lesion recurrence. However, in cases of subtotal resection, radiation therapy has been advised ( 17 , 81 ). Endovascular embolization has been recently used to remove a hemangioma, successfully minimizing blood loss during the operation ( 82 ).…”

Section: Discussionmentioning

confidence: 99%

“…Hemangiomas are congenital vascular malformations whose pathologies are considered to be hamartomatous malformations ( 15 ). Spinal epidural hemangiomas (SEHs) can be divided into 2 types: epidural hemangiomas of vertebral origin, and primary epidural space hemangiomas ( 17 , 24 , 27 ). SEHs account for 4% of all spinal epidural tumors, mostly occurring as primary lesions in the vertebral bone ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Spinal Dumbbell Epidural Hemangioma: Two Stage/Same Sitting/Same Position Posterior Microsurgical and Transthoracic Endoscopic Resection – Case Report and Review of the Literature

Pojskić

Zbytek

Mutrie

et al. 2018

ACC

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SUMMARY – Spinal dumbbell tumors are defined by a narrowing at the point where they penetrate the intervertebral foramina or dura mater, assuming an hourglass or dumbbell shape. Dumbbell-shaped spinal hemangiomas are extremely rare. We describe a dumbbell spinal tumor (epidural cavernous hemangioma) resected by a 2-stage single-sitting combined approach. We also conduct a substantial literature review of the subject. We present a case of a 78-year-old male who was found to have a homogeneously enhancing, dumbbell-shaped, intraspinal, extradural tumor mass extending into the left chest cavity. The tumor was resected with a single-sitting 2-stage posterior technique: a microsurgical approach, followed by endoscopic resection via a thoracoscopic approach. There are several reports in the literature on the combined approach for dumbbell tumors of the spinal cord. Our case is the first to describe 2-stage combined surgery in 1 sitting for dumbbell hemangioma with the patient in the lateral decubitus position for the thoracoscopic part of the surgery; and the use of a fat pad, which was applied in the neuroforamen via the posterior route, as a marker for resection during the transthoracic procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spinal Dumbbell Epidural Hemangioma: Two Stage/Same Sitting/Same Position Posterior Microsurgical and Transthoracic Endoscopic Resection – Case Report and Review of the Literature

Pojskić

Zbytek

Mutrie

et al. 2018

ACC

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“…However, in this study, vertebral destruction was observed in 3 cases (Case 2, 5, and 7). In previous studies, homogeneous hypo-to isointensity signals were usually observed in the spinal cord on T1WI with hyperintense signals on T2WI, because of slow blood flow, together with an intense homogeneous signal on contrast enhancement (1,3,11,22,35). Besides, lesions with hemorrhage, liquefaction of a hematoma, or intravascular thrombosis can always show heterogeneous enhancement (9,16).…”

Section: Radiological Presentationmentioning

confidence: 94%

Spinal Epidural Cavernous Hemangiomas: A Clinical Series of 9 Cases and Literature Review

et al. 2021

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ObjectiveSpinal epidural cavernous hemangiomas are very rare vascular lesions and are, therefore, seldom reported and easily misdiagnosed. Herein, we present a series of 9 cases with spinal epidural cavernous hemangiomas and discuss their pathogenesis, clinical characteristics, radiological findings, differential diagnosis, surgical interventions, pathological characteristics, and prognosis.MethodsWe retrospectively retrieved and analyzed the data of patients with pure epidural cavernous hemangiomas, who underwent spinal magnetic resonance imaging, and surgical intervention at the First Hospital of Jilin University, China, between January 2005 and December 2019. The data on patients’ clinical manifestations, imaging characteristics, surgical intervention, histopathological findings, and postoperative follow-up were also recorded and analyzed.ResultsIn all, 5 men and 4 women with the mean age of 61 years (range, 41–78 years) were recruited. All patients experienced a gradual onset of symptoms and a slowly progressive clinical course, and no patient presented an acute onset of symptoms. The clinical manifestations include myelopathic signs in 8 patients (88.9%) and radicular symptoms in 3 patients (33.3%). On T1-weighted imaging, 6 lesions appeared isointense (55.6%), and 4 lesions exhibited hypointense (44.4%) signals. On T2-weighted imaging, 8 lesions appeared hyperintense (88.9%), and 1 lesion was heterogeneously intense (11.1%). Following gadolinium administration, 5 lesions appeared homogeneous with significant enhancement (55.6%), 1 lesion was homogeneous and mild enhancement (11.1%), and 3 lesions were heterogeneous with mild enhancement (33.3%). All patients received early microsurgery assisted by intraoperative electrophysiologic monitoring and neuronavigation in the lateral position via the posterior midline approach. Five patients underwent total laminectomy (55.6%), and 4 underwent hemilaminectomy (44.4%). Total excision was achieved in all cases. The average follow-up period was 55.1 months (ranging 10–123 months). All patients exhibited significant clinical improvement of their neurological deficits and achieved a favorable outcome with no recorded recurrence at last follow-up.ConclusionsSpinal epidural cavernous hemangiomas are rare vascular malformations. Early surgical treatment with total resection is an optimum treatment, particularly for patients with an acute exacerbation onset. The prognosis is mostly good and depends predominantly on the severity of the preoperative status.

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“…Rarely, even after its complete resection, symptoms may persist, perhaps because of scarring around the dural sac or the involved nerve root, and don't necessarily related to recurrence [4].…”

Section: Evolutionmentioning

confidence: 99%

“…It is an hyper vascular lesion with the risk of massive bleeding during the operation therefore the surgical procedure must be careful and total extirpation after coagulation is preferred [1] [9] [10].Totally removed, these tumors don't recur, and surgical treatment is sufficient. However, for patients with incomplete resection, radiation therapy can be suggested but still controversial [1][4].…”

mentioning

confidence: 99%

A Rare Cause of Lumbosciatialgia: Foraminal Lumbar Cavernous Hemangioma

Fakir¹,

Idrissi²,

Arharas³

et al. 2020

OALib

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Cavernous hemangiomas are a benign lesion that can affect any parth of the neurax. However, pure lumbar extradural localization is not common. Their ethiopatogenesis is uncertain and still debated but actually, they are considered as congenital vascular malformations. The clinical presentation is not specific, they can simulate any expansive process of the epidural space which makes the condition difficult to the preoperative diagnosis. Although unusual and in front of its eventual complications, foraminal cavernous hemangioma deserves to be considered in the differential diagnosis with spinal epidural soft tissue masses particularly those dumbbell shaped. Magnetic Resonance Imaging (MRI) is the chosen technique in the positive diagnosis and can help to evaluate the relationship of the lesion with surrounding anatomic structures to avoid intra-operative incidents. Total removal of the lesion, as early as possible, is the optimum treatment preserving the prognosis. We report a case of a patient suffering from lombosciatalgia secondary to a lumbar spinal extradural cavernous hemangioma. The purpose of this study is to highlight through this observation the role of magnetic resonance imaging in the diagnosis of this unusual cavernoma's localization.

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Spinal Epidural Cavernous Hemangioma: A Clinical Series of 7 Patients

Cited by 14 publications

References 24 publications

Spinal Dumbbell Epidural Hemangioma: Two Stage/Same Sitting/Same Position Posterior Microsurgical and Transthoracic Endoscopic Resection – Case Report and Review of the Literature

Spinal Dumbbell Epidural Hemangioma: Two Stage/Same Sitting/Same Position Posterior Microsurgical and Transthoracic Endoscopic Resection – Case Report and Review of the Literature

Spinal Epidural Cavernous Hemangiomas: A Clinical Series of 9 Cases and Literature Review

A Rare Cause of Lumbosciatialgia: Foraminal Lumbar Cavernous Hemangioma

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