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Review
. 2021 Jun 1;21(2):317-321.

Atypical vertebral hemangioma: an aggressive form of a benign disease. Case Report and Literature Review

Christos P Zafeiris  1 , Peter Lewkonia  2 , W Bradley Jacobs  1   3
Affiliations
Review

Atypical vertebral hemangioma: an aggressive form of a benign disease. Case Report and Literature Review

Christos P Zafeiris et al. J Musculoskelet Neuronal Interact. .

Abstract

Vertebral hemangiomas are an incidental and relatively common radiological finding and a benign tumor of vascular origin. VH are the most common spine tumors with an estimated incidence of 1.9-27% in the general population. Rarely, vertebral hemangiomas can exhibit extraosseous expansion with resulting compression of the spinal cord. Such lesions are termed aggressive or atypical vertebral hemangiomas (AVH) and account for less than 1% of spinal hemangiomas. A 68-year-old female was referred with progressive walking difficulty and sensory disturbances in her lower extremities. MRI imaging of the thoracic spine revealed a T1- and T2-weighted hyperintense lesion involving the T10 vertebra. Additionally, there was extraosseous extension of the tumor into the spinal canal, located both anterior and posterior to the spinal cord, causing severe spinal cord compression. A combined endovascular and surgical approach (arterial coil embolization and en bloc resection) for treatment was decided. Although vertebral hemangiomas are an incidental and relatively common radiological finding, the findings of our case were consistent with an aggressive hemangioma with atypical MRI and clinical prognostic characteristics. In summary, the present case highlights the need for multidisciplinary approach and in-depth knowledge of this rare pathologic entity.

Keywords: En Bloc Resection; Endovascular Embolization; Prognosis; Recurrence; Αggressive Vertebral Hemangiomas.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Figure 1
Figure 1
MRI Sagittal T1- weighted hyperintense lesion involving the T10 vertebral body.
Figure 2
Figure 2
MRI Sagittal T2- weighted hyperintense lesion involving the T10 vertebral body.
Figure 3
Figure 3
MRI Axial T2- weighted image of the T10 vertebra.
Figure 4
Figure 4
Lateral x-ray at presentation. Arrow on the T10 vertebra.
Figure 5
Figure 5
Angiographic image of the lesion.
Figure 6
Figure 6
Final result of the pre-operative embolization of the T10 vertebra.
Figure 7
Figure 7
Post-operative x-ray of the thoracic spine. The patient underwent a T10 en bloc resection with a T8-T12 fusion.
Figure 8
Figure 8
Post-operative x-ray of the thoracic spine. The patient underwent a T10 en bloc resection with a T8-T12 fusion.
See this image and copyright information in PMC

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