title: Juxtaposition of an epidural intraforaminal cavernous hemangioma and an intradural schwannoma.
abstract: METHODS
  A case of juxtaposition of a purely extradural cavernous hemangioma and an intradural schwannoma in the thoracic spine is reported.
  
  
  OBJECTIVE
  The objectives of this study were to present a rare and before-surgery unexpected combination of spinal tumors, which may complicate surgical removal; and to discuss the radiologic features and the possible pathogenesis of this combination of tumors and its implications on surgical therapy.
  
  
  BACKGROUND
  Juxtaposition of different spinal tumors is exceedingly rare in patients without neurofibromatosis. To the authors' knowledge, no combination of a purely epidural spinal cavernous hemangioma with an intradural schwannoma has been previously reported.
  
  
  METHODS
  A 47-year-old woman presented with progressive paraparesis. Magnetic resonance imaging revealed a partly cystic intradural mass at the T6-T7 level and a solid extradural intraforaminal component that demonstrated slightly different signal characteristics. An intra-/extradural schwannoma was assumed.
  
  
  RESULTS
  Surgical exposure displayed a highly vascularized lobulated mass within the left neuroforamen at T6-T7. There was no continuity with the larger intradural, cystic, and mildly vascularized lesion. Histologic examination diagnosed an extradural cavernous hemangioma and an intradural schwannoma.
  
  
  CONCLUSIONS
  The segmental juxtaposition of lesions should be considered in the differential diagnosis of spinal pathology.
authors.affiliation: Department of Neurosurgery, University Hospital Mannheim, Faculty for Clinical Medicine of the University of Heidelberg, Mannheim, Germany. claudius.thome@nch.ma.uni-heidelberg.de
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zevgaridis
authors.forename: Dejana
authors.initials: D
authors.lastname: Matejic
authors.forename: Clemens
authors.initials: C
authors.lastname: Sommer
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D015174:Epidural Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery