Aggressive Thoracic Hemangioma of Spine Presenting as Painful Adolescent Scoliosis - Diagnosis and Management.

INTRODUCTION

Spinal hemangioma is the most common benign lesion of the spine with an incidence of 10-12%. Aggressive hemangioma presents with back pain, deformity, or neurologic deficit. Aggressive hemangioma presenting as painful scoliosis is very rare and literature reporting them is very limited.

CASE REPORT

We present the case of a boy in his second decade who presented with back pain for 1 month radiating to his right chest with a deformity in his back. MRI showed a hyperintense lesion involving the sixth dorsal vertebra in the T2-weighted image and a hypointense lesion with striations in STIR images suggestive of hemangioma. Pre-operative embolization was done using micro platinum coils. The patient underwent a decompressive laminectomy and vertebral body decompression. The patient also underwent 12 cycles of radiotherapy. The patient had complete resolution of the deformity without any recurrence at 2 years.

CONCLUSION

Management of aggressive hemangiomas with neurologic deficit needs a multidisciplinary approach with surgery, pre-operative embolization, and post-operative radiotherapy.