Skip to main content
Erschienen in: European Spine Journal 2/2014

01.02.2014 | Review Article

Clinical and radiological presentation of spinal epidural haemangiomas: clinical series in a tertiary care centre during a 10-year period

verfasst von: Mario Mühmer, Richard Bostelmann, Sevgi Sarikaya-Seiwert, Marcel Schneiderhan, Hans-Jakob Steiger, Jan Frederick Cornelius

Erschienen in: European Spine Journal | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Haemangiomas are very frequent benign spinal tumours. However, pure epidural location is extremely rare. At present, only 52 cases have been reported in the literature during the last 10 years. We proposed to analyse clinical and radiological features of this rare entity treated in a tertiary care centre over the last 10 years.

Methods

A study of a retrospective surgical series (2002–2012) was conducted. The clinic’s electronic database was searched for “spinal” and/or “vertebral haemangiomas”, which were treated by surgery and/or vertebroplasty. Clinical, radiological and histopathological data were analysed.

Results

In total, the series comprised 30 spinal haemangiomas. There were 6 epidural (20 %), 17 vertebral (57 %) and 7 intradural lesions (23 %). There were four men and two women, mean age 28.3 years, with epidural lesions. One patient presented with localised back pain only, two with radiculopathy and focal neurological deficit, two with radiculopathy only and one with isolated focal neurological deficit, respectively. The onset of symptoms was progressive in four cases over weeks to months and sudden in two cases. Preoperative MRI imaging revealed features of meningioma, neurinoma or metastasis.

Conclusion

Epidural haemangiomas are extremely rare spinal lesions. They may mimic more common spinal tumours clinically and radiologically. The usual treatment is gross total resection confirming the diagnosis histologically.
Literatur
1.
Zurück zum Zitat Murugan L, Samson RS, Chandy MJ (2002) Management of symptomatic vertebral hemangiomas: review of 13 patients. Neurol India 50:300–305PubMed Murugan L, Samson RS, Chandy MJ (2002) Management of symptomatic vertebral hemangiomas: review of 13 patients. Neurol India 50:300–305PubMed
5.
Zurück zum Zitat Pastushyn AI, Slin’ko EI, Mirzoyeva GM (1998) Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol 50:535–547 PubMedCrossRef Pastushyn AI, Slin’ko EI, Mirzoyeva GM (1998) Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol 50:535–547 PubMedCrossRef
6.
Zurück zum Zitat Floeth F, Riemenschneider M, Herdmann J (2010) Intralesional hemorrhage and thrombosis without rupture in a pure spinal epidural cavernous angioma: a rare cause of acute lumbar radiculopathy. Eur Spine J 19(Suppl 2):S193–S196. doi:10.1007/s00586-010-1345-6 PubMedCrossRef Floeth F, Riemenschneider M, Herdmann J (2010) Intralesional hemorrhage and thrombosis without rupture in a pure spinal epidural cavernous angioma: a rare cause of acute lumbar radiculopathy. Eur Spine J 19(Suppl 2):S193–S196. doi:10.​1007/​s00586-010-1345-6 PubMedCrossRef
7.
Zurück zum Zitat Sarikaya-Seiwert S, Gierga K, Wessalowski R, Steiger HJ, Hanggi D (2010) Solitary spinal epidural cavernous angiomas in children presenting with acute neurological symptoms caused by hemorrhage. J Neurosurg Pediatr 5:89–93. doi:10.3171/2009.7.PEDS09203 PubMedCrossRef Sarikaya-Seiwert S, Gierga K, Wessalowski R, Steiger HJ, Hanggi D (2010) Solitary spinal epidural cavernous angiomas in children presenting with acute neurological symptoms caused by hemorrhage. J Neurosurg Pediatr 5:89–93. doi:10.​3171/​2009.​7.​PEDS09203 PubMedCrossRef
8.
Zurück zum Zitat Faria SL, Schlupp WR, Chiminazzo H Jr (1985) Radiotherapy in the treatment of vertebral hemangiomas. Int J Radiat Oncol Biol Phys 11:387–390PubMedCrossRef Faria SL, Schlupp WR, Chiminazzo H Jr (1985) Radiotherapy in the treatment of vertebral hemangiomas. Int J Radiat Oncol Biol Phys 11:387–390PubMedCrossRef
9.
Zurück zum Zitat Aoyagi N, Kojima K, Kasai H (2003) Review of spinal epidural cavernous hemangioma. Neurol Med Chir (Tokyo) 43:471–475 (discussion 476)CrossRef Aoyagi N, Kojima K, Kasai H (2003) Review of spinal epidural cavernous hemangioma. Neurol Med Chir (Tokyo) 43:471–475 (discussion 476)CrossRef
12.
Zurück zum Zitat Conti P, Pansini G, Mouchaty H, Capuano C, Conti R (2004) Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol 61:34–43 (discussion 44). pii: S0090301903005378PubMedCrossRef Conti P, Pansini G, Mouchaty H, Capuano C, Conti R (2004) Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol 61:34–43 (discussion 44). pii: S0090301903005378PubMedCrossRef
14.
Zurück zum Zitat Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP (1997) Cavernous angiomas of the spinal district: surgical treatment of 11 patients. Eur Spine J 6:298–303PubMedCentralPubMedCrossRef Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP (1997) Cavernous angiomas of the spinal district: surgical treatment of 11 patients. Eur Spine J 6:298–303PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Abdullah DC, Raghuram K, Phillips CD, Jane JA Jr, Miller B (2004) Thoracic intradural extramedullary capillary hemangioma. AJNR Am J Neuroradiol 25:1294–1296 pii: 25/7/1294PubMed Abdullah DC, Raghuram K, Phillips CD, Jane JA Jr, Miller B (2004) Thoracic intradural extramedullary capillary hemangioma. AJNR Am J Neuroradiol 25:1294–1296 pii: 25/7/1294PubMed
17.
22.
Zurück zum Zitat Goyal M, Mishra NK, Sharma A, Gaikwad SB, Mohanty BK, Sharma S (1999) Alcohol ablation of symptomatic vertebral hemangiomas. AJNR Am J Neuroradiol 20:1091–1096PubMed Goyal M, Mishra NK, Sharma A, Gaikwad SB, Mohanty BK, Sharma S (1999) Alcohol ablation of symptomatic vertebral hemangiomas. AJNR Am J Neuroradiol 20:1091–1096PubMed
23.
Zurück zum Zitat Heyd R, Seegenschmiedt MH, Rades D, Winkler C, Eich HT, Bruns F, Gosheger G, Willich N, Micke O (2010) Radiotherapy for symptomatic vertebral hemangiomas: results of a multicenter study and literature review. Int J Radiat Oncol Biol Phys 77:217–225. doi:10.1016/j.ijrobp.2009.04.055 PubMedCrossRef Heyd R, Seegenschmiedt MH, Rades D, Winkler C, Eich HT, Bruns F, Gosheger G, Willich N, Micke O (2010) Radiotherapy for symptomatic vertebral hemangiomas: results of a multicenter study and literature review. Int J Radiat Oncol Biol Phys 77:217–225. doi:10.​1016/​j.​ijrobp.​2009.​04.​055 PubMedCrossRef
25.
Zurück zum Zitat Badinand B, Morel C, Kopp N, Tran Min VA, Cotton F (2003) Dumbbell-shaped epidural capillary hemangioma. AJNR Am J Neuroradiol 24:190–192PubMed Badinand B, Morel C, Kopp N, Tran Min VA, Cotton F (2003) Dumbbell-shaped epidural capillary hemangioma. AJNR Am J Neuroradiol 24:190–192PubMed
26.
27.
Zurück zum Zitat Nagi S, Megdiche H, Bouzaidi K, Haouet S, Khouja N, Douira W, Sebai R, Chaabene S, Zitouna M, Touibi S (2004) Imaging features of spinal epidural cavernous malformations. J Neuroradiol 31:208–213 pii: MDOI-JNR-06-2004-31-3-0150-9861-101019-ART05PubMedCrossRef Nagi S, Megdiche H, Bouzaidi K, Haouet S, Khouja N, Douira W, Sebai R, Chaabene S, Zitouna M, Touibi S (2004) Imaging features of spinal epidural cavernous malformations. J Neuroradiol 31:208–213 pii: MDOI-JNR-06-2004-31-3-0150-9861-101019-ART05PubMedCrossRef
28.
Zurück zum Zitat Thome C, Zevgaridis D, Matejic D, Sommer C, Krauss JK (2004) Juxtaposition of an epidural intraforaminal cavernous hemangioma and an intradural schwannoma. Spine (Phila Pa 1976) 29:E524–E527 pii: 00007632-200411150-00026CrossRef Thome C, Zevgaridis D, Matejic D, Sommer C, Krauss JK (2004) Juxtaposition of an epidural intraforaminal cavernous hemangioma and an intradural schwannoma. Spine (Phila Pa 1976) 29:E524–E527 pii: 00007632-200411150-00026CrossRef
29.
Zurück zum Zitat Cheng LT, Lim WE (2005) Spinal epidural haemangioma associated with extensive gastrointestinal haemangiomas. A case report. Interv Neuroradiol 11:161–166 pii: IN.v11.i2.p161PubMedCentralPubMed Cheng LT, Lim WE (2005) Spinal epidural haemangioma associated with extensive gastrointestinal haemangiomas. A case report. Interv Neuroradiol 11:161–166 pii: IN.v11.i2.p161PubMedCentralPubMed
31.
Zurück zum Zitat Hatiboglu MA, Iplikcioglu AC, Ozcan D (2006) Epidural spinal cavernous hemangioma. Neurol Med Chir (Tokyo) 46:455–458 pii: JST.JSTAGE/nmc/46.455CrossRef Hatiboglu MA, Iplikcioglu AC, Ozcan D (2006) Epidural spinal cavernous hemangioma. Neurol Med Chir (Tokyo) 46:455–458 pii: JST.JSTAGE/nmc/46.455CrossRef
32.
Zurück zum Zitat Jo BJ, Lee SH, Chung SE, Paeng SS, Kim HS, Yoon SW, Yu JS (2006) Pure epidural cavernous hemangioma of the cervical spine that presented with an acute sensory deficit caused by hemorrhage. Yonsei Med J 47:877–880 pii: 200612877PubMedCentralPubMedCrossRef Jo BJ, Lee SH, Chung SE, Paeng SS, Kim HS, Yoon SW, Yu JS (2006) Pure epidural cavernous hemangioma of the cervical spine that presented with an acute sensory deficit caused by hemorrhage. Yonsei Med J 47:877–880 pii: 200612877PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Lee JW, Cho EY, Hong SH, Chung HW, Kim JH, Chang KH, Choi JY, Yeom JS, Kang HS (2007) Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation. AJNR Am J Neuroradiol 28:1242–1248. doi:10.3174/ajnr.A0563 PubMedCrossRef Lee JW, Cho EY, Hong SH, Chung HW, Kim JH, Chang KH, Choi JY, Yeom JS, Kang HS (2007) Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation. AJNR Am J Neuroradiol 28:1242–1248. doi:10.​3174/​ajnr.​A0563 PubMedCrossRef
35.
Zurück zum Zitat Hakan T, Demir M, Aker F, Berkman M (2007) Pregnancy-related spinal epidural capillary-cavernous haemangioma: magnetic resonance imaging and differential diagnosis. Australas Radiol 51 Spec No.:B6–9. doi:10.1111/j.1440-1673.2007.01775.x Hakan T, Demir M, Aker F, Berkman M (2007) Pregnancy-related spinal epidural capillary-cavernous haemangioma: magnetic resonance imaging and differential diagnosis. Australas Radiol 51 Spec No.:B6–9. doi:10.​1111/​j.​1440-1673.​2007.​01775.​x
38.
Zurück zum Zitat Satpathy DK, Das S, Das BS (2009) Spinal epidural cavernous hemangioma with myelopathy: a rare lesion. Neurol India 57:88–90PubMedCrossRef Satpathy DK, Das S, Das BS (2009) Spinal epidural cavernous hemangioma with myelopathy: a rare lesion. Neurol India 57:88–90PubMedCrossRef
41.
Zurück zum Zitat Uchida K, Yayama T, Nakajima H, Hirai T, Kobayashi S, Chen K, Guerrero AR, Baba H (2010) Microsurgical resection of cavernous haemangioma around the thoracic neuroforamen: a case report. J Orthop Surg (Hong Kong) 18:370–373 Uchida K, Yayama T, Nakajima H, Hirai T, Kobayashi S, Chen K, Guerrero AR, Baba H (2010) Microsurgical resection of cavernous haemangioma around the thoracic neuroforamen: a case report. J Orthop Surg (Hong Kong) 18:370–373
Metadaten
Titel
Clinical and radiological presentation of spinal epidural haemangiomas: clinical series in a tertiary care centre during a 10-year period
verfasst von
Mario Mühmer
Richard Bostelmann
Sevgi Sarikaya-Seiwert
Marcel Schneiderhan
Hans-Jakob Steiger
Jan Frederick Cornelius
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 2/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3045-5

Weitere Artikel der Ausgabe 2/2014

European Spine Journal 2/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.