Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.
Spinal Cord Ser Cases. 2024 Jul 15;10(1):48. doi: 10.1038/s41394-024-00655-0.
Pure epidural spinal cavernous hemangiomas are rare, benign vascular tumors that account for approximately 4% of all spinal epidural tumors. Due to their dumbbell shape and propensity for foraminal invasion, they are often misdiagnosed and inadequately treated. We present a case of a 58-year-old male with extra-osseous cavernous hemangioma to better aid in diagnosis and management of these lesions.
A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. He underwent resection with histopathologic exam revealing a pure epidural cavernous hemangioma.
Spinal epidural cavernous hemangiomas are exceedingly rare lesions that are often misdiagnosed as nerve sheath tumors and meningiomas. Common features include chronic pain and myelopathy as well as T1 isodensity, T2 hyperintensity, and homogenous enhancement. Uniquely, they present as a lobulated, spindled shape with tapered ends in the dorsal epidural space. Both gross and subtotal resection result in favorable neurologic outcomes.
单纯硬膜外脊髓海绵状血管瘤是一种罕见的良性血管肿瘤，约占所有脊髓硬膜外肿瘤的 4%。由于其哑铃状的形状和椎间孔侵犯的倾向，它们经常被误诊和治疗不当。我们报告一例 58 岁男性的硬膜外海绵状血管瘤病例，以更好地帮助诊断和治疗这些病变。
一名 58 岁男性因慢性腰痛、进行性下肢无力、T10 感觉水平、下肢本体感觉缺失、反射亢进和一次肠失禁就诊。影像学显示 T7-T10 均匀性背侧硬膜外肿块导致脊髓信号改变。他接受了切除术，组织病理学检查显示为单纯硬膜外海绵状血管瘤。
脊髓硬膜外海绵状血管瘤是非常罕见的病变，常被误诊为神经鞘瘤和脑膜瘤。常见特征包括慢性疼痛和脊髓病以及 T1 等密度、T2 高信号和均匀强化。其独特之处在于在背侧硬膜外间隙呈分叶状、梭形，两端逐渐变细。大体和次全切除均能获得良好的神经功能结局。
