대한흉부영상의학회 Weekly Chest Cases

Case No : 284 Date 2003-04-05

Courtesy of Woo Kyung Jung, M.D., Yo Won Choi, M.D. / Hanyang University Seoul Hospital, Seoul, Korea
Age/Sex 21 / M
Chief ComplaintNo specific symptom. Incidental detected mass.

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Diagnosis With Brief Discussion

Diagnosis: Epidural Hemangioma
Radiologic Findings: Well circumscribed mass on the left side of thoracic vertebra is noted. On CT, the mass is attached to the costovertebral junction, and the medial part of the mass is enhanced very well. The mass shows a dumbbell shape with both intra- and extraspinal components. MR shows the low- to iso-signal intensity on T1 weighted scan, high signal intensity on T2 weighted scan and strong enhancement on postenhanced T1 weighted image. The lobulated contour of mass is also noted. Increased vascularity was noted during operative removal of the mass.
Brief Review: Primary epidural hemangiomas without adjacent vertebral involvement are rare, accounting for <4% of all spinal epidural masses. Capillary hemangiomas are the more common form, however cases of these in the epidural locations are very rare. The pathologic features are as follow; these lesions consist of capillary-sized vessels lined with flattened endothelium separated by a collagenous stroma. The most frequent level is the thoracic region, followed by the lumbar and cervical regions. The morphologic features of epidural hemangiomas are the lobulated contour of tumors, and this findings help to be differentiated from the neurogenic tumors which have smooth contour. On MR, the tumor is isointense to the spinal cord on T1-weighted images and hyperintense on T2-weighted images and showed homogeneous, strong enhancement.
References: 1. Shin JH, Lee HK, Rhim SC et al. Spinal epidural cavernous hemangioma: MR findings. J Comput Assist Tomogr, 25(2): 257-261.
2. Gupta S, Kumar S, Banerji D, et al. Magnetic resonance imaging features of an epidural spinal haemangioma. Austral Radiol, 40:342-344
3. Shin JH, Lee HK, Sang RJ et al. Spinal intradural capillary hemangioma: MR findings. Am J Neuroradiol, 21: 954-956
Keywords: Paravertebral, Benign tumor,

No. of Applicants : 31

▶ Correct Answer : 3/31, 9.7%

- Chung Li Ten-Chen Hospital,Taiwan Gui-Lin Zheng
- National Medical Center, Korea Sang Kyu Yang
- National Taiwan University Hospital, Taiwan Kao-Lang Liu

▶ Semi-Correct Answer : 28/31, 90.3%

- Annecy Hospital, France Gilles Genin
- Asan Medical Center, Korea Eun Jin Chae
- China Medical College Hospital, Taichung, Taiwan Tsai Po-Pang
- CHRU Lille, France Philippe Dumont
- CHU Grenoble, France Mathieu Rodiere
- CHU Nancy-Brabois, France Denis Regent
- Chungju Hospital Konkuk University, Korea Chang Hee Lee
- Dept of IM, Seoul National University Hospital, Korea Changmin Choi
- Ewha Womans' University Hospital, Korea Sung Shine Shim
- GeumGang Asan Hospital, Korea Ju Youn Park
- Gwangmoung Seongae Hospital, Korea Jiyong Rhee
- Hangang Sacred Heart Hospital, Korea Eil Seong Lee
- Incheon Sarang Hospital, Korea Jung Hee Kim
- Jecheon Public Health Center, Korea Seung Hun Ryu
- Kangbuk Samsung Hospital, Korea Semin Chong
- Korean National Institute of Health, Korea Sang-Min Lee
- MH(CTC), Pune, India Vivek Sharma
- Narayana Hrudayalaya, Bangalore, India Nisha Sreenivasan
- Ohio State University, Ohio, USA Sumit Seth
- Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
- Ospedale di Jesi, Italy Giancarlo Passarini
- Prever-Centro Radiologico, Brazil Arismar Leon Pereira
- Samsung Medical Center, Korea Sun Young Jeong
- Samsung Medical Center, Korea Yeon Joo Jeong
- Social Security Hospital, Ankara, Turkey Meric Tuzun
- Tokyo Kouseinenkin Hospital , Japan Noriatsu Ichiba
- Ulsan University Hospital, Korea Kwang-Won Seo
- Xray clinic pune, Korea Anand Rahalkar

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 284 Date 2003-04-05

Discussion

No. of Applicants : 31