Thoracic Intra and Extramedullary Capillary Hemangioma with Subacute Clinical Course: A Case Report and Literature Review

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  • YAMAMOTO Yumeki
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • SHIMAUCHI-OHTAKI Hiroya
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • HONDA Fumiaki
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • SHIRAKURA Takahiro
    Department of Human Pathology, Gunma University Graduate School of Medicine
  • ARAMAKI Keigo
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • SHINTOKU Ryosuke
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • MIYAGISHIMA Takaaki
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • AIHARA Masanori
    Department of Neurosurgery, Gunma University Graduate School of Medicine
  • YOKOO Hideaki
    Department of Human Pathology, Gunma University Graduate School of Medicine
  • YOSHIMOTO Yuhei
    Department of Neurosurgery, Gunma University Graduate School of Medicine

Abstract

<p>Capillary hemangiomas are benign tumors comprising a lobulated proliferation of capillary vessels frequently located in the soft tissues of the neck and head. Spinal intradural capillary hemangiomas are rare, particularly intramedullary lesions. To our knowledge, only 31 cases of spinal intramedullary capillary hemangiomas have been reported. Here, we describe a rare case of a thoracic capillary hemangioma comprising extramedullary and intramedullary components. A 51-year-old male patient presented with bilateral lower extremity numbness and subsequent paraparesis, sensory disturbance, and bladder-bowel dysfunction with a subacute clinical course. Magnetic resonance imaging revealed a mass lesion with intramedullary and intradural extramedullary components at the Th9-10 vertebrae level and widespread spinal cord edema. Contrast-enhanced computed tomography revealed abnormal vessels on the dorsal spinal cord surface. Spinal angiography revealed a light-stained mass lesion fed by the radiculopial artery from the right Th11 intercostal artery. The tumor was resected en bloc, and the histological diagnosis was a capillary hemangioma. Postoperatively, the spinal cord edema diminished, and the patient was discharged from the convalescent rehabilitation ward. Although intramedullary capillary hemangioma is a rare spinal tumor and its preoperative diagnosis is difficult, it should be considered in the differential diagnosis of spinal intramedullary tumors.</p>

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