title: Epidural Venous Angioma Presenting with Spinal Cord Compression in a 42-Year-Old Woman with Previous History of Ovarian Malignancy.
abstract: BACKGROUND
  Venous angioma is an extremely rare vascular malformation of the epidural space. To the best of our knowledge, only 5 cases have been documented to date and none has been reported in the setting of a previous malignancy.
  
  
  METHODS
  We report the case of a 42-year-old woman with a previous history of ovarian cancer, treated by surgery plus chemotherapy; who presented with signs of spinal cord compression for 3 weeks. Magnetic resonance imaging showed an intensely enhancing epidural mass at the T2-T6 level causing major spinal cord compression, for which urgent surgery was indicated. During surgery, the tumor was extremely hemorrhagic and the hemostasis was hazardous. Blood loss was estimated at 1.5 L, causing hemodynamic instability and requiring intensive resuscitation with fluids and blood transfusions. Gross total resection was achieved and the pathologic examination confirmed the diagnosis of venous angioma. The patient recovered quickly postoperatively and was able to walk independently within 2 weeks of starting intensive rehabilitation. She was symptom free with no clinical or radiologic evidence of recurrence at 1 year follow-up.
  
  
  CONCLUSIONS
  Venous angioma should be included in the differential diagnosis of spinal epidural masses even in case of previous malignancy. Subtle imaging features should alert clinicians to this rare yet potentially life-threatening condition. Surgery remains the cornerstone of the treatment and can result in remarkable recovery.
authors.affiliation: Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia. Electronic address: atefbn@hotmail.fr.
authors.forename: Atef
authors.initials: A
authors.lastname: Ben Nsir
authors.affiliation: Department of Pathology, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia.
authors.forename: Rym
authors.initials: R
authors.lastname: Hadhri
authors.affiliation: Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kilani
authors.affiliation: Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chabaane
authors.affiliation: Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Darmoul
authors.affiliation: Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia.
authors.forename: Nejib
authors.initials: N
authors.lastname: Hattab
mesh_terms: D020787:Central Nervous System Venous Angioma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D015174:Epidural Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Epidural; Spinal cord; Surgery; Venous angioma