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Rapid growth of spinal epidural capillary hemangioma associated with isolated intraosseous lesion at the same level: A case report


Journal of Neurology & Stroke
Kazuma Doi,1,2 Yukoh Ohara,1,2 Takeshi Hara,Hirokazu Iwamuro,2 Kei Miyagawa,2 Nozomu Kobayashi,2 Tatsuya Sato,2 Takatoshi Okuda,2 Hidetoshi Nojiri,2 Junichi Mizuno,1 Akira Dezawa3

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Abstract

A 47-year-old man presented with a spinal epidural capillary hemangioma manifesting as a 6-month history of worsening low back pain and lower limb pain. Computed tomography and magnetic resonance imaging (MRI) at a previous hospital showed intraosseous abnormal signals and an epidural lesion at the L3 level. One month later, MRI revealed rapid growth of the epidural lesion. Total resection of the epidural tumor and partial removal of the intraosseous tumor were performed. Macroscopically, the intraosseous lesion and epidural lesion seemed to be isolated from each other. Histopathological diagnosis was consistent with capillary hemangioma. Spinal epidural capillary hemangioma sometimes recurs via underlying arteriovenous anastomosis. Progressive clinical symptoms, as seen in our case, indicate the possibility of tumor growth even if the lesions are well demarcated, which suggests of benign tumor. Spinal epidural capillary hemangioma in addition to metastatic spinal tumors should be considered in the differential diagnosisof spinal epidural tumors associated with intraosseous lesions.

Keywords

capillary hemangioma, rapid growth, epidural, arteriovenous anastomosis, bony involvement

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