Presentation
Paraparesis.
Patient Data
Well-circumscribed epidural mass of posterior location extending from T5-T6 to T8-T9 level. It displays an isointense signal to the spinal cord on T1, high signal on T2 and STIR with no restricted diffusion, containing small signal void serpiginous vascular structures with vivid homogeneous enhancement on postcontrast sequences. There is an extension through the adjacent intervertebral foramina with vertebral erosion. The adjacent segment of the spinal cord is compressed and displaced anteriorly.
Small vertebral hemangiomas of T7 and T10 vertebral bodies are noted.
Case Discussion
MRI features of a vividly enhancing spinal epidural mass extending through the intervertebral foramina, compressing the spinal cord, most consistent with epidural hemangioma.
On imaging, the main differential diagnoses of spinal epidural hemangiomas include 1,2:
granulomatous infection