Introduction

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.

Case Presentation

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.

Conclusion

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.

中文翻译：

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纯硬膜外骨外海绵状血管瘤伴胸段脊髓病：病例报告及文献复习

 介绍

纯硬膜外椎管内海绵状血管瘤是罕见的良性血管肿瘤，约占所有椎管内硬膜外肿瘤的 4%。由于其哑铃形状和侵入椎间孔的倾向，它们经常被误诊和治疗不充分。我们介绍了一名患有骨外海绵状血管瘤的 58 岁男性病例，以更好地帮助诊断和治疗这些病变。

 案例展示

一名 58 岁男性，出现慢性腰痛、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。影像学显示 T7-T10 均质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纯硬膜外海绵状血管瘤。

 结论

脊髓硬膜外海绵状血管瘤是极其罕见的病变，经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 高信号和均匀增强。独特的是，它们呈分叶状、纺锤形，在背侧硬膜外腔中具有锥形末端。大体切除和次全切除都会产生良好的神经系统结果。