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Gil GDAN, Gravina DDS, Cobalchini GR, Bossardi PB, Giustina PGD. Aggressive Thoracic Spine Hemangioma in a 13-Year-Old Boy: A Case Report with Literature Review. J Orthop Case Rep 2025; 15:141-145. [PMID: 40351614 PMCID: PMC12064237 DOI: 10.13107/jocr.2025.v15.i05.5588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Revised: 03/19/2025] [Indexed: 05/14/2025] Open
Abstract
Introduction Most vertebral hemangiomas are latent and don't not require specific treatment; few cases present with symptoms, usually pain. Rarely, they manifest aggressively, causing neurological deficits from spinal cord compression. Case Report This case report describes a 13-year-old boy whose gait disturbance investigation revealed an aggressive T6 hemangioma. Conclusion Diagnosis is typically determined by imaging changes. Surgical treatment is indicated for cases with neurological deficits. Emergency decompression with laminectomy is required for rapid, progressive deficits, with radiotherapy considered based on extraosseous involvement. Level of Evidence IV. Case report.
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Affiliation(s)
| | | | | | - Pedro Bertoldo Bossardi
- Department of Orthopedic and Trauma Surgery, Ecossistema de Saúde Pompeia, Caxias do Sul, RS, Brazil
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Adin ME, Woolf G, Hegde R, Elsamadicy AA, Mendel E, Zucconi WB, Pucar D, Aygün N. Sacral tumors: a comprehensive review of imaging, diagnostic challenges, and tumor mimics. Skeletal Radiol 2025:10.1007/s00256-024-04862-6. [PMID: 39821683 DOI: 10.1007/s00256-024-04862-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 12/23/2024] [Accepted: 12/29/2024] [Indexed: 01/19/2025]
Abstract
The sacrum can harbor a diverse group of both benign and malignant tumors, including metastases. Primary tumors of the sacrum can arise from bone, cartilage, marrow, notochordal remnants, or surrounding nerves and vessels. Among a variety of primary tumors of the spine, chordoma, germ cell tumors and Ewing's sarcoma are recognized for their propensity to occur in the sacrum. Imaging is essential in diagnosis, pretreatment evaluation, and assessment of response to treatment. Radiography, CT and MRI are the primary modalities in assessing morphology and tumor extent whereas PET/CT is crucial in the evaluation of systemic disease in the setting of myeloma, lymphoproliferative disease, and metastasis. A definitive diagnosis is not always achievable by imaging as some tumors lack specific imaging features. However, as we detail in this comprehensive review, many entities have characteristic clinical and epidemiological factors as well as typical imaging findings that can help make either a confident diagnosis or offer a narrow list of differentials. We discuss a wide range of benign and malignant, primary, and secondary tumors that can involve the sacrum, highlighting the pertinent clinical details and typical imaging findings of these entities, enabling the reader to develop and apply a systematic approach to evaluating sacral masses on imaging. We also briefly describe non-neoplastic tumor mimics, which include developmental entities, infections, and insufficiency fractures.
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Affiliation(s)
- Mehmet Emin Adin
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street TE 2, P.O. Box 208042, New Haven, CT, 06520-8042, USA.
| | - Graham Woolf
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street TE 2, P.O. Box 208042, New Haven, CT, 06520-8042, USA
| | - Rahul Hegde
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street TE 2, P.O. Box 208042, New Haven, CT, 06520-8042, USA
| | | | - Ehud Mendel
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - William B Zucconi
- Department of Radiology, Dartmouth Geisel School of Medicine, Dartmouth, NH, USA
| | - Darko Pucar
- Department of Nuclear Medicine, Cleveland Clinic Florida, Weston, FL, USA
| | - Nafi Aygün
- Department of Radiology, Moffit Cancer Center Florida, Tampa, FL, USA
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Timilsina K, Shrestha S, Bhatta OP, Paudel S, Lakhey RB, Pokharel RK. Atypical Aggressive Hemangioma of Thoracic Vertebrae Associated With Thoracic Myelopathy-A Case Report and Review of the Literature. Case Rep Orthop 2024; 2024:2307950. [PMID: 39165484 PMCID: PMC11335424 DOI: 10.1155/2024/2307950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/05/2024] [Accepted: 08/02/2024] [Indexed: 08/22/2024] Open
Abstract
Aggressive thoracic hemangiomas are rare, benign tumors that extend into the spinal canal and cause neurological symptoms. Delayed diagnosis and treatment, due to a paucity of literature on optimal treatment strategies, can increase morbidity. This case report describes a 19-year-old male patient with aggressive thoracic hemangioma who presented with upper back pain and progressive weakness of the lower extremities. The patient underwent preoperative embolization and sclerotherapy, followed by decompression, posterior instrumentation, and stabilization. The final diagnosis was confirmed by biopsy, and there was a significant improvement in neurology after the surgical intervention. The diagnosis of rare lesions, such as aggressive hemangiomas, requires a high level of clinical suspicion and the assistance of imaging modalities in patients with features of compressive myelopathy. A combination of endovascular and surgical approaches can lead to optimal outcomes.
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Affiliation(s)
| | - Sandesh Shrestha
- Department of Orthopaedics and Trauma SurgeryTribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Sushil Paudel
- Department of Orthopaedics and Trauma SurgeryTribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Rajesh Bahadur Lakhey
- Department of Orthopaedics and Trauma SurgeryTribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Rohit Kumar Pokharel
- Department of Orthopaedics and Trauma SurgeryTribhuvan University Teaching Hospital, Kathmandu, Nepal
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Kuo A, Ahorukomeye P, Gordon ZL. Aggressive thoracic vertebral hemangioma: case report and literature review. Spinal Cord Ser Cases 2023; 9:20. [PMID: 37210382 PMCID: PMC10199886 DOI: 10.1038/s41394-023-00577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/14/2023] [Accepted: 05/11/2023] [Indexed: 05/22/2023] Open
Abstract
INTRODUCTION Vertebral hemangiomas are common and typically benign vascular lesions, with a prevalence of 10-12% in the general population and 2-3% in all spine tumors. A small subset of vertebral hemangiomas can be categorized as "aggressive" if they exhibit extraosseous expansion that compress the spinal cord, causing pain and various neurologic symptoms. This report details a case of aggressive thoracic hemangioma resulting in worsening pain and paraplegia to draw attention to this rare condition, including identification and treatment. CASE PRESENTATION In this case, we present a 39 year-old female with a history of progressively worsening pain and paraplegia caused by compression of the spinal cord from an aggressive thoracic vertebral hemangioma. Clinical presentation, imaging, and biopsies, confirmed the diagnosis. A combined surgical and endovascular treatment strategy was implemented, and the patient's symptoms improved. DISCUSSION Aggressive vertebral hemangioma is a rare condition that may cause symptoms that diminishes the quality of life, including pain and various neurological symptoms. Given the low number of such cases, and significant impact on lifestyle, it is beneficial to identify cases of aggressive thoracic hemangiomas to ensure timely and accurate diagnosis and help development of treatment guidelines. This case highlights the importance of identifying and diagnosing this rare but serious disease.
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Affiliation(s)
- Andy Kuo
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Peter Ahorukomeye
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
| | - Zachary L Gordon
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
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Thoracic spine hemangioma causing rapidly progressive myelopathy and mimicking a malignant tumor: A case report. Radiol Case Rep 2021; 16:938-941. [PMID: 33659033 PMCID: PMC7890091 DOI: 10.1016/j.radcr.2021.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/23/2022] Open
Abstract
Vertebral hemangiomas are common benign tumors that are mostly asymptomatic and are discovered incidentally. Only 0.9–1.2% of all vertebral hemangiomas, termed aggressive vertebral hemangiomas, expand to cause pain and neural compression. We present an extremely rare case of a 49-year-old woman who had an aggressive vertebral hemangioma of the thoracic spine that caused rapidly progressive myelopathy with remarkable irregular extraosseous bone proliferation, which mimicked a malignant vertebral tumor. In this case, despite the lesion's hostile appearance during imaging, the pathological diagnosis was benign and symptom-based surgical treatment with posterior decompression and stabilization provided good clinical outcomes during the postoperative 18 months follow-up period. In this case, despite the use of standard imaging modalities (radiograph, CT, and MRI), making a preoperative imaging diagnosis of an aggressive vertebral hemangioma was difficult, and although aggressive vertebral hemangiomas with atypical radiological features are rare, they should be considered as a differential diagnosis.
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Papadakos D, Boulieris S, Theofanopoulos A, Fermeli D, Constantoyannis C. Tubular laminectomy and percutaneous vertebroplasty for aggressive vertebral hemangioma. Surg Neurol Int 2021; 12:27. [PMID: 33598343 PMCID: PMC7881512 DOI: 10.25259/sni_888_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Vertebral hemangiomas (VH) are the most common benign vascular neoplasms of the spine. Aggressive VH (AVH) may become symptomatic due to soft-tissue expansion/extraosseous extension into the paraspinal and/or epidural spaces. There are several options for treating painful AVH, including radiotherapy and/or open surgery. Case Description: A 59-year-old male presented with a 2-year history of intermittent back pain and progressive thoracic myelopathy in the past 2 months. MRI revealed a T9 level lesion, with high-intensity signal on both T1 and T2 images and an extraosseous component with significant cord compression. We performed minimally invasive tubular unilateral laminotomy for bilateral decompression of the thoracic spine at the T9 level, followed by bilateral percutaneous vertebroplasty with biopsy. Postoperatively, the pain was immediately relieved, and the myelopathy improved. The biopsy confirmed the diagnosis of a VH. Conclusion: Combining minimally invasive techniques consisting of tubular laminectomy and percutaneous vertebroplasty are safe and effective ways for treating AVHs.
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Affiliation(s)
- Dimitrios Papadakos
- Department of Neurosurgery, University Hospital of Patras, Rio University Hospital, Patras, Achaia, Greece
| | - Spiros Boulieris
- Department of Neurosurgery, University Hospital of Patras, Rio University Hospital, Patras, Achaia, Greece
| | - Andreas Theofanopoulos
- Department of Neurosurgery, University Hospital of Patras, Rio University Hospital, Patras, Achaia, Greece
| | - Dionysia Fermeli
- Department of Neurosurgery, University Hospital of Patras, Rio University Hospital, Patras, Achaia, Greece
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Kasch R, Scheele J, Hancock M, Hofer A, Maher C, Bülow R, Lange J, Lahm A, Napp M, Wassilew G, Schmidt CO. Prevalence of benign osseous lesions of the spine and association with spinal pain in the general population in whole body MRI. PLoS One 2019; 14:e0219846. [PMID: 31498790 PMCID: PMC6733514 DOI: 10.1371/journal.pone.0219846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/03/2019] [Indexed: 01/16/2023] Open
Abstract
Background Benign osseous lesions of the spine are common but precise population prevalence estimates are lacking. Our study aimed to provide the first population-based prevalence estimates and examine association with back and neck pain. Materials and methods We used data from the population-based Study of Health in Pomerania (SHIP). Whole-body MRI examinations (1.5 Tesla: T1, T2, and TIRM weightings) were available from 3,259 participants. Readings of the spinal MRI images were conducted according to a standardized protocol by a single reader (JS). The intra-rater reliability was greater than Kappa values of 0.98. Pain measures included the seven-day prevalence of spine pain and neck pain, and average spine pain intensity due to spine pain during the past three months. Results We found 1,200 (36.8%) participants with at least one osseous lesion (2,080 lesions in total). Osseous lesions were less common in men than in women (35.5% vs 38.9%; P = .06). The prevalence of osseous lesions was highest at L2 in both sexes. The prevalence of osseous lesions increased with age. Up to eight osseous lesions were observed in a single subject. Hemangioma (28%), and lipoma (13%) occurred most often. Sclerosis (1.7%), aneurysmal bone cysts (0.7%), and blastoma (0.3%) were rare. Different osseous lesions occurred more often in combination with each other. The association with back or neck pain was mostly negligible. Conclusion Osseous lesions are common in the general population but of no clinical relevance for spinal pain. The prevalence of osseous lesions varied strongly across different regions of the spine and was also associated with age and gender. Our population-based data offer new insights and assist in judging the relevance of osseous lesions observed on MRIs of patients.
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Affiliation(s)
- Richard Kasch
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
- * E-mail:
| | - Josephin Scheele
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Mark Hancock
- Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Sydney, Australia
| | - André Hofer
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Christopher Maher
- The University of Sydney, Sydney School of Public Health, NSW, Sydney, Australia
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Jörn Lange
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Department of Trauma Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Lahm
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
- Kliniken Maria Hilf Mönchengladbach, Academic Teaching Hospital of the RWTH Aachen, Mönchengladbach, Germany
| | - Matthias Napp
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Department of Trauma Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Georgi Wassilew
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Carsten Oliver Schmidt
- Institute for Community Medicine, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
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Aggressive Hemangioma of the Thoracic Spine with Cord Compression: A Case Report. JOURNAL OF ORTHOPEDIC AND SPINE TRAUMA 2017. [DOI: 10.5812/jost.65088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Recurrent solitary fibrous tumor of lumbar spine with vertebral body involvement: imaging features and differential diagnosis with report of a case. Radiol Case Rep 2016; 11:450-455. [PMID: 27920879 PMCID: PMC5128393 DOI: 10.1016/j.radcr.2016.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/16/2016] [Accepted: 08/21/2016] [Indexed: 11/21/2022] Open
Abstract
Solitary fibrous tumors (SFTs) of the spine are exceedingly rare tumors of mesenchymal origin. Most spinal SFTs arise from the thoracic spine, followed by cervical spine, and last lumbar spine with only 6 cases reported in literature. SFTs represent a wide range of neoplasms, ranging from benign to malignant. These tumors can develop a late recurrence, even after a decade or more of initial presentation, requiring long-term follow-up. We present a case of recurrent SFT of the lumbar spine with vertebral body involvement, presenting more than a decade after initial resection. It was initially misdiagnosed as a paraganglioma. To the best of our knowledge, there have been only 3 previous cases reporting SFT with vertebral body involvement.
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Abstract
A case of a 42-year-old man with back pain associated with left radiculopathy and infiltrative mass involving the T12 and L5 vertebrae is described. Magnetic resonance imaging (MRI) and computed tomography indicated aggressive hemangiomas involving the T12 and L5 vertebrae. Three-year follow-up by imaging indicated minimally increased aggressiveness of the L5 lesion without any significant change in appearance of the T12 lesion thus, confirming the initial diagnosis of multiple aggressive vertebral hemangiomas.
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Affiliation(s)
- Parag Suresh Mahajan
- Department of Clinical Imaging, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Vidya Chander Negi
- Department of Clinical Imaging, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar
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Li W, Zou F, Dai M, Zhang B, Nie T. A rare case of pure primary hemangioma of the scapula: A case report. Oncol Lett 2015; 10:2265-2268. [PMID: 26622831 DOI: 10.3892/ol.2015.3596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 05/12/2015] [Indexed: 01/25/2023] Open
Abstract
Hemangioma is a benign vascular tumor, which may occur in any bone of the body. The most common locations are the spine and craniofacial bone; however, occurrence is extremely rare in the scapula. The current study presented the case of a 58-year-old female, with scapula hemangioma in the left shoulder who presented with joint ache that had lasted for ~1 year. The main clinical manifestations included local tenderness, an osseous lump and limited shoulder movement with a little pain, which was alleviated by rest. Roentgenogram, computed tomography and magnetic resonance imaging of the left acromion revealed a mass along the inner surface of the scapula of the left shoulder with polycystic expansion and bone destruction. The results of computed tomography and magnetic resonance imaging indicated a pure primary tumor and the lesion was subsequently resected. Notably, the postoperative pathological diagnosis was capillary hemangioma. The aim of the present study was to analyze the clinical and imaging features of scapula hemangioma, which must be considered for the differential diagnosis of scapula tumors. In the present case, no recurrence was identified by X-ray examination 1 year after surgery. The long-term efficacy of surgical treatment requires continuous observation of the patient.
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Affiliation(s)
- Wei Li
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Fan Zou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Multidisciplinary Therapy Center of Musculoskeletal Tumor, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Tao Nie
- Multidisciplinary Therapy Center of Musculoskeletal Tumor, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Jain RS, Agrawal R, Srivastava T, Kumar S, Gupta PK, Kookna JC. Aggressive vertebral hemangioma in the postpartum period: an eye-opener. Oxf Med Case Reports 2014; 2014:122-4. [PMID: 25988053 PMCID: PMC4370026 DOI: 10.1093/omcr/omu048] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 09/25/2014] [Accepted: 09/30/2014] [Indexed: 11/13/2022] Open
Abstract
Pregnancy is a well-known risk factor for incidental or asymptomatic vertebral hemangiomas becoming aggressive or symptomatic, most often during the third trimester of pregnancy, related to hemodynamic and endocrinal changes occurring during pregnancy. Many patients show spontaneous incomplete remission after delivery. We report a rare case of aggressive vertebral hemangioma in the postpartum period in a 26-year-old woman, who presented with upper backache with progressive spastic paraparesis.
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Affiliation(s)
- Rajendra Singh Jain
- Department of Neurology , S.M.S. Medical College , Jaipur, Rajasthan , India
| | - Rakesh Agrawal
- Department of Neurology , S.M.S. Medical College , Jaipur, Rajasthan , India
| | | | - Sunil Kumar
- Department of Neurology , S.M.S. Medical College , Jaipur, Rajasthan , India
| | - Pankaj Kumar Gupta
- Department of Neurology , S.M.S. Medical College , Jaipur, Rajasthan , India
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Magnetic resonance spectroscopy (MRS) of vertebral column - an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesion. Radiol Oncol 2014; 48:137-41. [PMID: 24991203 PMCID: PMC4078032 DOI: 10.2478/raon-2013-0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 12/16/2012] [Indexed: 11/27/2022] Open
Abstract
Background Most vertebral haemangioma are asymptomatic and discovered incidentally. Sometimes the symptomatic lesions present with radiological signs of aggressiveness and their appearance resemble other aggressive lesions (e.g. solitary plasmacytoma). Case report. We present a patient with large symptomatic aggressive haemangioma like lesion in 12th thoracic vertebra in which a magnetic resonance spectroscopy (MRS) was used to analyse fat content within the lesion. The lesion in affected vertebrae showed low fat content with 33% of fat fraction (%FF). The fat content in non-affected (1st lumbar) vertebra was as expected for patient’s age (68%). Based on MRS data, the lesion was characterized as an aggressive haemangioma. The diagnosis was confirmed with biopsy, performed during the treatment – percutaneous vertebroplasty. Conclusions The presented case shows that MRS can be used as an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesions.
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