Symptomatic Vertebral Hemangioma in a Young Child

Abstract

Vertebral hemangiomas (VHs) are the most common benign vertebral neoplasm and typically are asymptomatic, only to be discovered incidentally on imaging from the fourth to fifth decade of life. Seldom do they enlarge to a point of compression, causing pain and focal neurologic deficits. We present the rare case of an 8-year-old female who presented with paraparesis after a fall. Imaging revealed a pathological fracture of the T8 vertebra with retropulsion and spinal cord compression from both fracture and epidural tumor tissue. The patient underwent an anterior and posterior removal of the tumor, decompression, and fusion. Pathological report of specimen biopsy confirmed a benign hemangioma. To the best of our knowledge, this is the same age as the youngest previously reported case of symptomatic VH and it is the longest to be recurrence-free at follow-up. The hemangioma was successfully treated with tumor removal, decompression, and fusion. No adjuvant treatment was required, and she remained asymptomatic without recurrence at her 4-year follow-up.

An Uncommon Cause of Back Pain in an Adolescent Patient

“…However, in some cases, they can lead to back pain and, more rarely, compression of the spinal cord or nerve roots, resulting in sensory and motor deficits. [1][2][3][4] In cases associated with pain, the latter is often localized, worse at night and can be exacerbated by physical activity. 1,3 In symptomatic VH without neurologic involvement, the literature recommends annual neurological and imaging examinations upon surveillance and medical treatment.…”

“…This may include endovascular embolization, vertebroplasty, alcohol injection, radiotherapy or surgical decompression. [1][2][3][4] Contributorship Statement / Declaração de Contribuição JFP: Conception, writing of the manuscript, and preparation of the images.…”