1. Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2. Department of Neurosurgery, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
Spinal capillary hemangioma: Report of five surgical cases and literature review
1. Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2. Department of Neurosurgery, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
摘要 Objective: Capillary hemangioma is a benign vascular malformation that is usually encountered in soft-tissue. Rarely, it may occur in the neuraxis, and spinal capillary hemangioma (SCH) is a rare variant of it. Existing literature on SCH is limited because of its rarity. As a result, epidemiological and clinical characteristics as well as management strategy for SCH are still lacking. Here, we present a report on five patients with pathologically proven SCH, treated in Beijing Tiantan Hospital between 2013 and 2015. Methods: Patients' age, gender, clinical manifestations, radiological features, operative methods, and surgical outcomes were retrospectively reviewed, and an updated review of the literature was also provided. Results: Four patients were men and one was a woman, with a median age at presentation of 43 years (range: 15-66 years). Two lesions were intramedullary, two epidural, and one intradural extramedullary. The thoracic segment was most commonly affected (n = 3, 60%), followed by the cervical (n = 1, 20%) and lumbar (n = 1, 20%) segments. Common symptoms, in descending order, were numbness and paresthesia, limb weakness, and pain. The surgical procedure was successfully performed with total resection of the tumor achieved in 4 patients and subtotal in 1 patient. During an average follow-up period of 32 months (range: 27-43 months), recovery of the clinical symptoms was observed in all five patients. Conclusions: SCH is a rare benign vascular disease, for which surgical resection of the lesion, by the en bloc method, is recommended. Clinically, it usually manifests with progressive myelopathy, but early surgical intervention usually produces good results and may prevent permanent neurological deficits.
Abstract: Objective: Capillary hemangioma is a benign vascular malformation that is usually encountered in soft-tissue. Rarely, it may occur in the neuraxis, and spinal capillary hemangioma (SCH) is a rare variant of it. Existing literature on SCH is limited because of its rarity. As a result, epidemiological and clinical characteristics as well as management strategy for SCH are still lacking. Here, we present a report on five patients with pathologically proven SCH, treated in Beijing Tiantan Hospital between 2013 and 2015. Methods: Patients' age, gender, clinical manifestations, radiological features, operative methods, and surgical outcomes were retrospectively reviewed, and an updated review of the literature was also provided. Results: Four patients were men and one was a woman, with a median age at presentation of 43 years (range: 15-66 years). Two lesions were intramedullary, two epidural, and one intradural extramedullary. The thoracic segment was most commonly affected (n = 3, 60%), followed by the cervical (n = 1, 20%) and lumbar (n = 1, 20%) segments. Common symptoms, in descending order, were numbness and paresthesia, limb weakness, and pain. The surgical procedure was successfully performed with total resection of the tumor achieved in 4 patients and subtotal in 1 patient. During an average follow-up period of 32 months (range: 27-43 months), recovery of the clinical symptoms was observed in all five patients. Conclusions: SCH is a rare benign vascular disease, for which surgical resection of the lesion, by the en bloc method, is recommended. Clinically, it usually manifests with progressive myelopathy, but early surgical intervention usually produces good results and may prevent permanent neurological deficits.
20180119183930 Table 1 Characteristics of five patients with spinal capillary hemangioma.
20180119183938 Figure 1 Tissue section stained for hematoxylin and eosin. Histological analysis showed a relatively well-circumscribed pro liferation of capillary size vessels along with spindle cells. Original magnification ×100.
20180119183958 Figure 2 Preoperative magnetic resonance images. (a) Sagittal T2-weighted image shows the area around a well-circumscribed lesion, isointense (arrow) relatively to the spinal cord at the L3 level. Contrast-enhanced T1-weighted sagittal (b), coronal (c), and axial (d) images show strong enhancement of the tumor. The tumor appears as a solid mass, with clear margins.
20180119184015 Figure 3 Postoperative magnetic resonance images. (a) Postoperative sagittal T2-weighted image and sagittal (b), coronal (c), and axial images (d) after contrast injection show complete resection of the tumor.
20180119184027 Table 2 Summary of baseline characteristics of 65 patients with spinal capillary hemangioma
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2017, Vol. 3 
