14 July 2022>: Articles
Lumbar Spinal Epidural Capillary Hemangioma: A Case Report and Literature Review
Mistake in diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)Shiying Wu B* , Krishan Kumar Sharma B , Chi Long Ho A
Am J Case Rep 2022; 23:e936181
Figure 1. Magnetic resonance imaging (MRI) of a 38-year-old woman with spinal capillary hemangioma. (A) Sagittal T1-weighted (w) non-contrast image shows a well-defined T1 iso- and hyperintensity lesion relative to the spinal cord at the L1–L2 level (arrow). The tumor effaces the posterior epidural fat (arrowheads). (B) Sagittal T2w image shows a hyperintense extradural tumor (arrow) forming an obtuse angle (red-dotted lines and elbow connector arrow) with adjacent CSF. As the extradural tumor is covered anteriorly by an overlying dura, it gives the appearance of “marble under the carpet” where the marble represents the tumor (arrow) and the carpet resembles the dura mater. (C) Sagittal T1w fat-saturated post-contrast image reveals a well-defined and avid enhancing extradural tumor (arrow) displacing cauda equina nerve roots anteriorly within the spinal canal. The tumor effaces the posterior epidural fat without involving the posterior elements of the vertebrae (arrowheads). (D) Axial T1w pre-contrast image shows the extradural tumor (arrow) symmetrically displacing and indenting dura and cauda equina anteriorly. (E, F) Axial T2w images demonstrate the T2 hyperintense tumor (arrows) causing anterior displacement of the cauda equina nerve roots (arrowhead) within the spinal canal. The intraspinal nerve roots are arranged in a curvilinear fashion, surrounded by a thin rim of CSF at L1–2 level (arrowheads). (G) Axial T1w fat-saturated and post-contrast image shows the well-defined and avid enhancing extradural lesion (arrow) measuring approximately 1.1×2.0×5.0 cm (anteroposterior x transverse x craniocaudal) in size. It displaces the cauda equina nerve roots anteriorly within the spinal canal. The intraspinal nerve roots are arranged in a curvilinear fashion, surrounded by a thin rim of CSF at L1–2 level (arrowhead).