Spinal Epidural Cavernous Hemangioma Resembling a Metastatic Tumor in an 89-year-old Man: A Case Report

ABSTRACT

Cavernous hemangioma is a vascular malformation that can be encountered in any organ of the body; however, purely epidural cavernous hemangioma is a rare entity with a benign nature. The authors report a case of thoracic epidural cavernous hemangioma in an 89-year-old man with radiologic findings resembling those of a metastatic spinal tumor. Initially, the patient refused surgery because of his age and presumed malignancy. However, due to the progression of bilateral leg weakness, he later underwent total mass removal and decompression without neurological deficit. Intraoperative findings and a postoperative biopsy revealed cavernous hemangioma. Because initial radiological findings may suggest a malignant nature for several benign pathologies, the authors recommend that, unless malignancy is proven, aggressive tissue biopsy and treatment should be considered, even in elderly patients.