Extended epidural cavernous hemangioma of thoracic spine of a 68-year-old patient: case report and literature review
Author(s): ,
E. Kokkinakis
G. Kougentakis
Department of Neurosurgery, University of Heraklion, Crete, HERACLION, Greece
C. Tsitsipanis
Department of Neurosurgery, University of Heraklion, Crete, HERACLION, Greece
A. Vakis
Department of Neurosurgery, University of Heraklion, Crete, HERACLION, Greece
EANS Academy. Kokkinakis E. 10/21/18; 225814; EP1114
Emmanouil Kokkinakis
Emmanouil Kokkinakis
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We report a case of a patient with an extended epidural cavernous hemangioma of thoracic spine, who was admitted with mild neurological signs despite having a considerable degree of spinal cord compression caused by the mass. Magnetic resonance imaging study highlighted schwannoma as the most possible diagnosis. AVMs without bony involvment constitute 4% of the epidural tumors, resulting to being misdiagnosed.

The patient was a 68-year-old male, who was admitted to hospital solely with zosteroid pain of dermatomal distribution. The patient underwent surgery during which the lesion was elaborately removed. The mass was located epidurally and extramedullary. It caused compression and displacement of the spinal cord to the left. Histological examination revealed cavernous hemangioma, removal of which was complete.
The relevant literature has been reviewed. Pubmed-medline and data base cochrane were searched. Key words such as epidural spinal cavernouswere used to pinpoint to related articles for further study.

Post-operatively, the zosteroid pain subsided promptly and the patient showed no neurological signs. A few days later the patient was discharged from hospital. On follow-up with magnetic resonance imaging residual pathology was not detected.

Epidural cavernous hemangiomas, especially without bony involvement is a rare pathogenic entity, whose MRI may be misleading in relation to the diagnosis. Despite all this, it should not be underestimated but be part of differential diagnosis, bearing in mind that proper and prompt approach as well as complete removal of the AVM contribute to complete neurologic patient recovery.

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