# Thoracic cavernous hemangioma mimicking an epidural neurinoma in an hourglass shape: a case report and review of the literature

## TL;DR

A rare case of a spinal cavernous hemangioma was mistaken for a neuroma due to its hourglass shape but was successfully treated with surgery.

## Contribution

This case highlights the diagnostic challenge of thoracic cavernous hemangioma mimicking an epidural neuroma.

## Key findings

- The lesion displayed hourglass radiological features typical of an epidural neuroma.
- Histological confirmation revealed it was a cavernous hemangioma.
- Surgical removal led to a favorable postoperative outcome.

## Abstract

Epidural cavernous hemangioma is a rare vascular malformation, accounting for 5-12% of all spinal cord vascular malformations. We report a case of low dorsal spinal cord compression at D5-D6 due to a cavernous hemangioma mimicking the clinical and radiological features of an epidural neuroma in an hourglass shape. The clinical presentation was progressive spastic paraplegia over six months in a 41-year-old patient with no significant medical history. Magnetic resonance imaging showed a compressive D5-D6 intradural lesion with T2 hyperintensity, displaying an hourglass appearance suggestive of an epidural neuroma, with a significant extracanal component filling the ipsilateral latero-vertebral space. Histological examination confirmed cavernous hemangioma by immunohistochemistry. The postoperative outcome was favorable following total surgical removal of the lesion.