EPIDURAL CAVERNOUS HEMANGIOMA OF THE SPINAL CORD. CASE REPORT AND REVIEW OF THE LITERATURE. Petrosyan T, Zisakis A, Markogiannakis G, Hadjigeorgiou GF, Mylonakis I, Kelesis C, Panteli A, Varsos V Department of Neurosurgery, Red Cross Hospital, Athens, Greece Keywords: Langerhans cell histiocytosis, thoracic spine

 Cavernous hemangiomas are histologically benign vascular malformations and are considered amartoma growths. They are rarely found in the spine and usually involve the vertebral bodies with secondary extension in the epidural space. Introduction

 The epidural cavernous hemangioma of the spine, without bone involvement, is a very rare condition with about 80 cases reported in the bibliography. Introduction

 A woman 75 years old was admitted to our clinic with a history of a 5 month gradual weakness and hypesthesia in her lower extremities. MRI of the thoracic spine revealed an intracanalicular epidural lesion at T11-T12 with intense enhancement after contrast administration and displacement of the spinal cord, without infiltration of any bony structures. Material and Methods

 The patient underwent a laminectomy of T10, T11, T12 vertebrae. The lesion had epidural localization with some extension to the right T11-T12 vertebral foramen, without adhesion to the dura or spinal nerves, and was totally removed. Material and Methods

 Histological examination of the lesion showed that it was a cavernous hemangioma. Postoperatively the patient symptoms gradually resolved. Results

Pre-operative MRI

Results Post-operative MRI 3-months post-op 1-year post-op

 The primary epidural cavernous hemangioma although a rare condition must be included in the differential diagnosis of epidural spinal tumors. Early diagnosis by clinical examination and imaging with MRI followed by complete surgical removal of the lesion is associated with excellent prognosis, avoiding potential massive hemorrhagic complications with devastating effects on the spinal cord. Discussion