title: A case of dumbbell-shaped epidural cavernous angioma in the lumbar spine.
abstract: BACKGROUND
  Most spinal cavernous haemangiomas occur in the vertebral body and purely extradural cavernous hemangiomas without any vertebral body involvement is rare and account for only 4% of all extradural spinal tumors. Dumbbell-shaped spinal cavernous angioma is extremely rare, only 10 cases have been reported in the literature.
  
  
  METHODS
  A 77-year-old female presented with a one-year history of lumbago and right-sided L3 dermatomal hypoesthesia. A dumbbell mass at the L2/3 vertebral level was identified on lumbar MRI. The lesion was irregularly shaped and isointense on T1W and hyperintense on T2W and DWI images with homogenous contrast enhancement. A presumptive diagnosis was schwannoma, but other malignant neoplasms were also considered because of its irregular shape, minimally dilated neural foramen and the involvement of the non-enhanced L3 nerve root. The patient underwent surgery with a lateral extracavitary approach. A histopathological examination revealed cavernous hemangioma.
  
  
  CONCLUSIONS
  Cavernous hemangioma should be included in the differential diagnosis of dumbbell-shaped spinal tumors when the intervertebral foramina is not highly dilated and non-enhanced nerve root is identified in the tumor.
authors.affiliation: Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yunoki
authors.affiliation: Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Uneda
authors.affiliation: Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Yoshino
keywords: Cavernous hemangioma; differential diagnosis; dumbbell; epidural; lumbar