Epidural capillary hemangioma of the thoracic spine

Background context: Capillary hemangioma, also known as an “Infantile hemangioma,” appears as a raised, red, lumpy lesion anywhere on the body. Most of the epidural hemangiomas described were cavernous hemangioma. Epidural capillary hemangiomas are exceedingly rare lesions. Thus far, only three cases have been reported.

Purpose: To describe an additional case of a purely epidural capillary hemangioma and discuss its clinical, radiological, therapeutic and prognostic features.

Case Presentation: A 57-years-old man complained of dorsal and back pain. Neurological examination revealed back tenderness and crural paraparesis. His reflexes were exaggerated, and Babinski sign was present on both sides. A magnetic resonance imaging showed an epidural lesion at the level of T10–12 that demonstrated extension with intense postgadolinium enhancement (Figure 1A. After laminectomy, a reddish epidural mass that extended into the right T11–12 foramina was revealed. Histopathological examination disclosed a vascular tumor composed of vessels of several calibers. This picture diagnosed a capillary hemangioma.

Conclusion: Pure epidural capillary hemangiomas are extremely rare lesions that should be included in the differential diagnosis of spinal epidural lesions. They must be differentiated from more common lesions, mainly schwanommas, especially due to the foraminal extension, which may differentiate them from cavernous hemangiomas. Surgical excision is mandatory and intervertebral foraminal extension may preclude gross total resection.

No conflict of interest has been declared by the author(s).