Case report: An epidural cavernous hemangioma mimicking a dumbbell-shaped neuroma
| Autor: | Riccardo Caruso, Luigi Marrocco, Mariangela Lombardi, Venceslao Wierzbicki, Emanuele Piccione, Valentina Martines |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Case Report Schwannoma Spinal tumor Epidural hemangioma Hemangioma Meningioma 03 medical and health sciences Neuroma 0302 clinical medicine Foramen medicine Spinal canal business.industry Rare spinal lesion medicine.disease Case report Differential diagnosis MRI Rare hemangioma body regions medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Radiology Neurosurgery business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction and importance Spinal epidural cavernous hemangiomas are a rare occurrence. This particular case is made even more distinctive by the fact that the lesion mimicked a dumbbell-shaped neuroma. Moreover, it had a very unique localization (wholly epidural, at cervical-thoracic -C7-D1- level). The importance of this case is linked not only to its remarkable rarity, but also to the diagnostic avenues explored. The surgery was carried out by Prof. Riccardo Caruso, Head of the Neurosurgical Department of the Military Hospital of Rome and Professor of Neurosurgery of Sapienza University of Rome, assisted by Dr. Luigi Marrocco, Senior Neurosurgeon of the Military Hospital of Rome. Postsurgical recovery was managed by Dr. Venceslao Wierzbicki, Senior Neurosurgeon of the Military Hospital of Rome. Case presentation In 2020, a 71 year-old man, suffering from intense pain in the left scapular region and in the ulnar area of the left forearm, underwent surgery for the removal of a spinal epidural cavernous hemangioma involving the left C7-D1 foramen. Prior to surgery, the lesion had been misdiagnosed as a neuroma by a radiologist. Clinical discussion In the Literature there are other, rare cases of hemangiomas partly located in the spinal canal, and partly located intra and extra foramen. In the case here presented, differential diagnosis as well as a potential Schwannoma, suggested by the dumbbell shape of the lesion, should have considered also the possibility of a meningioma. Two teams of radiologists examined the images, the radiologists of our team, Dr. Valentina Martines and Dr. Emanuele Piccione, thanks to a close inspection of the features of the lesion, postulated the extra-dural position. Other aspects of the scans were then analyzed to help guide future diagnosis of similar lesions. Conclusion With a spinal tumor affecting the foramen, a close examination of the images allows for accurate presurgical differential diagnosis, differentiating between the more frequent neuroma and other rarer tumors, such as a hemangioma. Highlights • Close examination of images is key to an accurate pre-surgical differential diagnosis for spinal tumors. • A very rare spinal hemangioma mimicked in shape a dumbbell-shaped neuroma • Considerations to be made when facing spinal lesions • How to tell apart a neuroma, a meningioma, and a hemangioma of the spine from scans • Rare case of spinal hemangioma in unique localization and presenting remarkable features |
| Databáze: | OpenAIRE |
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