Extraforaminal, thoracic, epidural cavernous haemangioma: case report with analysis of magnetic resonance imaging characteristics and review of the literature.

Abstract

A case of a solitary, thoracic, extradural, extraforaminal cavernous haemangioma causing a chronic neuralgia syndrome is presented. In the spectrum of spinal axis cavernous malformations, extradural lesions are exceedingly rare. A purely extraforaminal, paraspinal cavernous haemangioma has never been previously reported. A 56-year-old woman suffered from a chronic neuralgia syndrome at the right D3 dermatome. Conservative treatment was ineffective. MRI revealed an extraforaminal mass at T3-4 which homogeneously enhanced after Gadolinium administration mimicking a schwannoma. The lesion was completely removed via an extraforaminal approach. Histopathological investigation revealed a cavernous haemangioma. The patient recovered completely within 4 weeks after surgery. Cavernous haemangiomas are developmental vascular hamartomas representing a single entity regardless of their location. As purely epidural lesions are rare, their clinical and radiological presentation could be confusing if located foraminally or extraforaminally. Thus, their signal characteristics providing valuable information will facilitate diagnosis and treatment.