Spinal cavernoma

Case contributed by A.Prof Frank Gaillard

Presentation

Rapid onset upper and lower limb symptoms.

Patient Data

Age: 65 years
Gender: Female
MRI

MRI of the spine demonstrates an intramedullary lesion which intrinsic high T1 signal and no convincing enhancement. It is surrounded by very low signal on T2 weighted images, which demonstrates blooming on gradient echo. 

Annotated image

Complete hemosiderin ring (red arrow) demonstrates blooming on gradient echo sequences (yellow arrow). Intrinsic high T1 signal (blue arrow) is visible on both pre and post contrast sequences and should bot be mistaken for contrast enhancement. 

MICROSCOPIC DESCRIPTION: The section shows a nidus of large and small calibre vascular  channels. No elastic tissue is identified in the walls of these  vessels. The lumen of one of the large vessels is filled with blood  clot.

FINAL DIAGNOSIS:  Features suggestive of vascular malformation; no evidence of tumour seen. 

Case Discussion

It is always important to remember that not all spinal cord masses are tumours, and that lesions which would be simple to diagnose in the brain, can mimic spinal cord tumours. The absence of any enhancement and the complete peripheral hemosiderin ring are helpful in this case. 

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Case information

rID: 19540
Case created: 21st Sep 2012
Last edited: 22nd Aug 2017
Tag: spine
Inclusion in quiz mode: Included

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