Agressive haemangioma

Case contributed by A/Professor Pramit Phal

Presentation

Back pain

Patient Data

Age: 41
Gender: Male
Modality: MRI

The body and left pedicle of T6 are largely replaced by hypointenseenhancing material. Changes in the trabecula and the cortex are also present and thefeatures are entirely in keeping with the clinical history of haemangioma. There isextraosseous haemangioma as well on the left lateral aspect of the vertebral body andalso in the left anterior and left lateral aspect of the epidural space at the samelevel. The combination of features results in minimal flattening of the lateraldiameters of the canal.

Similar changes are present in the left pedicle of T7. The extraosseous soft tissuematerial probably narrows the left T6-T7 exit foramen to a mild degree. It wouldrequire clinical correlation to determine whether the left T6 root is affected by thisprocess.

No other relevant abnormal finding.

COMMENT:

Bony haemangioma of the body and left pedicle of T6 and also at the left pedicle ofT7. There is a significant amount of intra and extradural extraosseous soft tissuematerial. At this stage this probably impacts upon the left T6 root at foramen leveland it displaces but does not compress the cord in the midthoracic region.

Modality: CT

CT GUIDED THORACIC VERTEBRAL BIOPSY

The procedure and rationale was discussed with the patient.

Left T7 pedicle was decided on for biopsy.

With patient prone, aseptic technique and intravenous sedation, periosteal local anaesthetic infiltration was used.

A 12G/13G bonopty bone biopsy needle was used to access the left pedicle, and solid core about 2.5 cm in length obtained along this path.

Case Discussion

Atypical or aggressive vertebral body haemangiomas can be challenging to manage if cord compression is present. 

PlayAdd to Share

Case Information

rID: 33881
Case created: 28th Jan 2015
Last edited: 25th Apr 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.