Capillary hemangioma of the thoracic spinal cord

Abstract

Capillary hemangiomas are common soft tissue tumors on the skin or mucosa of the head and neck in the early childhood, but very rare in the neuraxis. A 47-year-old man presented with one month history of back pain on the lower thoracic area, radiating pain to both legs, and hypesthesia below T7 dermatome. Thoracic spine MRI showed 1×1.3×1.5 cm, well-defined intradural mass at T6-7 disc space level, which showed isointensity to spinal cord on T1, heterogeneous isointensity on T2-weighted images, and homogeneous strong enhancement. The patient underwent T6-7 total laminotomy, complete tumor removal and laminoplasty. Histologically, the mass showed a capsulated nodular lesion composed of capillary-sized vascular channels, which were tightly packed into nodules separated by fibrous septa. These features were consistent with capillary hemangioma.

Keywords: Capillary hemangioma; Intradural extramedullary tumor; Spinal cord.

Fig. 1

Pre-operative spine magnetic resonance (MR) images. Thoracic spine MR scans show 1×1.3×1.5 cm sized, well-defined and intradural mass at T6-7 level, which compresses and displaces spinal cord ventrolaterally. The mass shows isointensity on T1-weighted images (A and D), heterogenous intensity on T2-weighted images (B and E) and homogeneous strong enhancement (C and F).

Fig. 2

Photographs of the capillary hemangioma. A : Lobular, capillary and hypercellular structure separated by fibrous tissue septa and fed by arteries (H&E, original magnification×100). B : Blood vessels vary in size from small lumina lined with endothelial cells to dilated vessels lined with flattened endothelium. Many scattered stromal lymphocytes are present (H&E, original magnification×400).