Agressive vertebral hemangioma in pregnancy

Case contributed by Zentout Sofiane

Presentation

Paraplegia in 37th week of pregnancy.

Patient Data

Age: 30 years
Gender: Female

There is an infiltrative mass with collapse involving the vertebral body, as well as the posterior elements of T5 vertebrae, appearing as low signal on T1 and high signal on T2 weighted images, and enhances avidly.

There is a significant epidural component resulting a spinal cord compression and edema. Bilateral extension of the foramina and the fifth left rib is noted.

Pathology revealed vertebral hemangioma with absence of malignancy.

Case Discussion

Vertebral hemangiomas are the most common benign vertebral tumors.

Aggressive vertebral hemangioma is rare, pregnancy is a risk factor, compression of inferior vena cava by the gravid uterus causes redistribution and increased blood flow volume through the vertebral venous plexus, and the hormonal changes during pregnancy cause expansion of vertebral hemangioma.

In the case of our patient, intraoperative findings suggested a vertebral mass, and the pathological diagnosis after surgery was hemangioma.

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