Vertebral Hemangioma Causing Cord Compression: A Case Report

Song, Jae Wook; Youn, Sang Min; Lee, Sang Hyung; Rhee, Chang Hoon; Lee, Seung Hoon; Lee, Jeung Hoon; Lee, Seung Sook

Abstract

We present a case of thoracic vertebral hemangioma causing spinal cord compression in a 57-year-old man. It is not common for vertebral hemangioma to cause neurologic deficits. The chief complaint of the patient was progressive paraparesis. Plain T-spine x-rays appeared normal. Axial and sagittal T1-weighted magnetic resonance(MR) imagings of T-spine showed multiple ring-like high signal lesion in vertebral body and decreased signal intensity at T7 with epidural mass causing spinal cord compression. Decompressive laminectomy and subtotal removal of the epidural mass were performed. The mass was reddish, friable and easily-coagulated. The postoperative computerized tomography(CT) scan of T-spine demonstrates characteristic thick vertical trabeculae and honeycomb pattern involving body and pedicles of T7 vertebrae. Bowel and urinary incontinence returned to normal two weeks following operation, and the patient was discharged with walking by sue of crutch three weeks later. Based on clinical features with this patient review of the literature, the authors recommend annual neurological and radiological examinations for patients harbouring hemangiomas with associated pain. Radiation therapy or embolization is an effective therapeutic alternative for patients with severe medically refractory pain. It is concluded that management of patients with a progressive neurological deficit should include prompt preoperative angiography and embolization, decompressive surgery with the approach determined by the degree of vertebral involvement and site of spinal cord compression, and postoperative radiation therapy in patients following subtotal tumor removal.