Thoracic Intradural Extramedullary Capillary Hemangioma
David C. Abdullaha,
Karthikram Raghurama,
C. Douglas Phillipsa,
John A. Jane, Jr.b and
Bradley Millerc
a Division of Neuroradiology, University of Virginia Health System, Charlottesville, VA
b Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA
c Division of Neuropathology, Department of Pathology, University of Virginia Health System, Charlottesville, VA
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FIG 1. Sagittal and axial MR images.
A and D, T1-weighted sagittal images, showing an intradural extramedullary lesion at T10 that is isointense relative to cord (single arrow). Preoperative appearance (A) and postoperative(D) changes are shown (double arrows).
B and E, Lesion is hyperintense on T2-weighted sagittal images (arrow). Postoperative changes are shown (large arrow, E).
C, Postcontrast T1-weighted axial image, showing intense enhancement of lesion (arrows).
F, Postcontrast T1-weighted sagittal image, showing intense tumor enhancement (lower arrow) and cranially draining dorsal enhancing perimedullary veins (upper arrow).
G, Postcontrast T1-weighted axial image showing enlarged enhancing draining veins on the dorsal surface of the cord above the lesion (arrows).
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FIG 2. Spinal arteriogram.
A, Early arterial phase image, showing a hypervascular nodule (large arrowhead) that demonstrates predominantly peripheral lobular inhomogeneous enhancement. Feeder from the left T11 intercostal artery (large single arrow), radiculomedullary feeder to the cord (single small arrow), and draining veins (double arrows) are seen.
B, Late arterial phase image, showing that the tumor nodule enhances more homogeneously (arrow).
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FIG 3. Hematoxyllin and eosin–stained microscopic image (Ocular 10x, Stage 40x). A, Stromal cells (large arrows) and endothelial cells (small arrows) lining the capillary spaces. Arrowheads at the top right point to normal neural tissue from the nerve root to which the tumor was attached.
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FIG 4. Postoperative MR images.
A, Sagittal T2-weighted image showing edema (arrow) in the spinal cord at the site of tumor resection.
B, Axial postcontrast image, showing enhancing dura (arrow) at the site of surgery, but no residual tumor.
C, Sagittal T1-weighted postcontrast image, showing enhancing dura (arrow) at the site of surgery, but no residual tumor.
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