title: Multilevel vertebral hemangiomas: two episodes of spinal cord compression at separate levels 10 years apart.
abstract: This case report presents a 66-year-old woman with multiple vertebral hemangiomas causing spinal cord compression at different levels with a long symptom-free interval between episodes of compression. She presented with back pain and progressive weakness and numbness in her lower limbs for 3 months. Ten years earlier, she had had a symptomatic T4 vertebral hemangioma operated successfully, and had made a full recovery. Magnetic resonance imaging (MRI) of the thoracic and lumbar spine revealed multiple thoracic and lumbar vertebral hemangiomas. Extraosseous extension of a hemangioma at T9 was causing spinal cord compression. Selective embolization was performed preoperatively, and cord decompression was achieved via anterior T9 corpectomy. The patient's neurological status improved rapidly after surgery. After a course of radiotherapy, she was neurologically intact and could walk independently. One year later, MRI showed complete resolution of the cord edema at T9, and showed regression of the high signal intensity that had been observed at unoperated levels. These findings indicated diminished vascularity and reduced aggression of the tumor.
authors.affiliation: Department of Orthopaedics and Traumatology, Baskent University, 06490 Ankara, Turkey. oguzk@baskent-ank.edu
authors.forename: Oguz
authors.initials: O
authors.lastname: Karaeminogullari
authors.forename: Cengiz
authors.initials: C
authors.lastname: Tuncay
authors.forename: Huseyin
authors.initials: H
authors.lastname: Demirors
authors.forename: Kayihan
authors.initials: K
authors.lastname: Akin
authors.forename: Orcun
authors.initials: O
authors.lastname: Sahin
authors.forename: Ayhan
authors.initials: A
authors.lastname: Ozyurek
authors.forename: Nevzat Reha
authors.initials: NR
authors.lastname: Tandogan
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000473:pathology / Q000628:therapy; D012008:Recurrence; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D013997:Time Factors