Spinal cavernoma

Case contributed by Dr Henry Knipe

Presentation

Left lower limb weakness and urinary retention.

Patient Data

Age: 30 years
Gender: Male
Modality: MRI

At the level of L1 there is an intramedullary mass located posteriorly. It has a low T1 and T2 rim anteriorly, and internally has a heterogeneous ("popcorn") T2 signal. High T1 and T2 signal surrounds the cord, which itself is mildly expanded. There is linear blooming artifact on GRE images. 

The patient proceeded to theatre and resection. 

Histopathology

MICROSCOPIC DESCRIPTION: The sections show a nidus of thin-walled vascular channels. These have a back-to-back arrangement with thin walls composed entirely of collagen. No elastic tissue or smooth muscle components are seen. Collections of haemosiderin-filled macrophages are noted at the edge of the lesion. The features are of a cavernous haemangioma. No evidence of tumour is seen.

DIAGNOSIS: Cavernous haemangioma.

Case Discussion

Imaging features are that of a spinal cavernoma, with characteristics "popcorn" appearance on T2WI. There is evidence of previous haemorrhage with linear blooming artifact and a low T1/T2 signal haemosiderin ring. High T2 cord signal and expansion suggests oedema, presumably secondary to recent bleeding and the cause of the patient's presentation. 

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Case Information

rID: 44033
Case created: 4th Apr 2016
Last edited: 8th Apr 2016
Inclusion in quiz mode: Included

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