Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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July 27, 2009
Epidural Spinal Hemangioma
- Hemangiomas are considered hamartomas or malformation of the microcirculation rather than vascular neoplasms.
- They are classified by the predominant type of vascular channel: capillary, cavernous, arteriovenous, or venous.
- Hemangiomas located in the epidural space are rare, more fequently of the cavernous type, account for 4% of all epidural tumors, and 12% of all intraspinal hemangiomas.
- Spinal epidural hemangiomas can have various MR features, but common features (despite histopathologic type) include lobular contour, a rim of low T2 signal intensity, and solid hypervascularity. T1 hyperintensity or multisegmental involvement may also be a clue in the differential diagnosis of a spinal epidural hemangioma.
- Differential diagnosis includes herniated disks (when ventral), synovial cysts, granulomatous infections, neurogenic tumors, lymphomas, meningiomas, angiolipoma, pure epidural hematoma, and epidural extramedullary hematopoiesis.
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