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Vertebral body hemangioma causing spinal cord compression 2005

General Spine

Peter x Kalina, MD
Norbert G Campeau , MD, Non ASSR Member

Excerpta

A 68-year-old man presented with progressive numbness and tingling in both legs, slowly progressing upward to lower abdomen. He had episodes of coldness or burning of his feet. His gait became increasing unsteady with occasional falls. Five years earlier he had a radical prostatectomy for prostate carcinoma. Physical exam revealed a sensory level just above the umbilicus level. There was marked loss of vibratory sensation in the lower limbs. MRI demonstrated an osseous lesion at T6 to T9 with associated epidural soft tissue mass and resultant cord compression. This was interpreted as metastatic diseases. Decompressive laminectomy with partial tumor resection was performed. Pathology revealed a benign hemangioma. Post-operative radiation was initiated. The patient made a significant neurologic recovery.

Asymptomatic intraosseous vertebral hemangiomas are common benign neoplasms. However, extraosseous extension of an aggressive vertebral hemangioma is a rare cause of thoracic spinal cord compression. In addition to CT and MRI, work-up may include angiography. Treatment options include surgery, radiation, embolization, vertebroplasty and sclerosis.