Intradural-Extramedullary Capillary Hemangioma with Acute Bleeding: Case Report and Literature Review

World Neurosurg. 2017 Dec:108:988.e7-988.e14. doi: 10.1016/j.wneu.2017.08.030. Epub 2017 Aug 18.

Abstract

Objectives: Capillary hemangiomas are benign vascular tumors. They are commonly founded in the vertebral bodies but very seldom in the spinal cord. The most common symptom at onset is long-lasting axial pain without neurologic deficit. In rare cases, the onset may be acute with neurological deficit due to an intratumoral hemorrhage.

Patient and methods: We report a case of a 58-year-old male with a history of 15 days upper back pain triggered by a mild traumatism that evolves acutely to paraplegia and urinary and fecal retention. An urgent MR showed an intradural lesion with signs of intratumoral haemorrhage.

Results: Urgent surgical intervention was performed and the anatomopathological results were capillary hemangioma. The symptoms of the patient improved after the surgery.

Conclusions: Intradural capillary hemangioma with acute intratumoral hemorrhage is a rare pathology, but it must be kept in mind because early diagnosis and treatment are key to achieve a good outcome. As far as we know, this is the first case reported of an intradural-extramedular capillary hemangioma that presents sudden neurologic deficit due to intratumoral bleeding.

Keywords: Acute neurologic deficit; Benign vascular tumor; Capillary hemangioma; Intratumoral hemorrhage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Back Pain / diagnostic imaging
  • Back Pain / etiology
  • Back Pain / pathology
  • Back Pain / surgery
  • Diagnosis, Differential
  • Hemangioma, Capillary / complications
  • Hemangioma, Capillary / diagnostic imaging
  • Hemangioma, Capillary / pathology
  • Hemangioma, Capillary / surgery*
  • Hemorrhage / complications
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / pathology
  • Hemorrhage / surgery*
  • Humans
  • Male
  • Middle Aged
  • Paraplegia / diagnostic imaging
  • Paraplegia / etiology
  • Paraplegia / pathology
  • Paraplegia / surgery
  • Spinal Cord Neoplasms / complications
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / surgery*