Thoracic Spinal Epidural Cavernous Hemangioma: A Case Report and Review of the Literature

ABSTRACT

We report a very rare case of thoracic epidural cavernous hemangioma in a 69-year-old male. He complained of a three-year history of dull ache at the interscapular region and progressive numbness and weakness of the lower extremities. He had been suffering from gait disturbance and difficulty in urination and defecation for the previous three months. Preoperative magnetic resonance images showed characteristic features a lobulated epidural mass, which was isointense to the spinal cord on T1-weighted images and hyperintense to the spinal cord on T2-weighted images, in the posterior spinal canal of the upper thoracic spine with contrast enhancement and extension through the intervertebral foramen. A right hemilaminectomy was performed at the T1, T2, T3 and T4 levels. After bilateral flavectomy, using a microsurgical technique, total excision of the mass was successfully achieved. The patient improved dramatically, both in motor strength and sensations, after the operation. Presumptive preoperative diagnosis of epidural cavernous hemangioma could render the surgical approach less invasive to avoid severe intraoperative bleeding.