Lumbar Extradural Hemangiomas: Report of Three Cases

• Published in: American journal of neuroradiology : AJNR Vol. 20; no. 1; pp. 27 - 31
• Main Authors: Rovira, Antoni, Rovira, Alex, Capellades, Jaume, Zauner, Martin, Bella, Rosa, Rovira, Mariana
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.01.1999; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Biological and medical sciences; Diagnosis, Differential; Epidural Neoplasms - diagnosis; Female; Hemangioma - diagnosis; Hemangioma, Cavernous - diagnosis; Humans; Lumbosacral Region; Magnetic Resonance Imaging; Medical sciences; Middle Aged; Neurology; Tomography, X-Ray Computed; Vascular diseases and vascular malformations of the nervous system; Human; Nervous system diseases; Radiodiagnosis; Lumbar spine; Cardiovascular disease; Exploration; Congenital disease; Nuclear magnetic resonance imaging; Cavernous angioma; Vascular disease; Case study; Extradural; Pathology; Central nervous system disease; Medical imagery; Computerized axial tomography; Benign neoplasm; Spinal cord disease; Arteriovenous malformation
• ISSN: 0195-6108; 1936-959X

The CT, MR, and histologic findings of three patients with surgically proved lumbar extradural cavernous and arteriovenous hemangiomas are reported. All three patients suffered from radicular and low back pain that disappeared completely or nearly so after total surgical excision. In each case, neuroimaging studies showed a well-defined ventrally located extradural mass with no bone involvement. On MR images, all lesions were homogeneous and isointense on noncontrast T1-weighted images and hyperintense on T2-weighted images relative to the intervertebral disk. Homogeneous enhancement was seen in one of the two cases in which contrast-enhanced T1-weighted images were obtained. Purely extradural hemangiomas should be included in the differential diagnosis of lumbar extradural soft-tissue lesions. Features that may help to distinguish this entity from the more common extruded disk herniation or neurogenic tumors are its homogeneous high signal intensity on T2-weighted images, ovoid shape, and lack of anatomic relationship with the adjacent intervertebral disk or exiting nerve root.