Lumbar extradural hemangiomas: Report of three cases

The CT, MIR, and histologic findings of three patients with surgically prov ed lumbar extradural cavernous and arteriovenous hemangiomas are reported, All three patients suffered from radicular and low back pain that disappear ed completely or nearly so after total surgical excision, In each case, neu roimaging studies showed a well defined ventrally located extradural mass w ith no bone involvement. On MR images, all lesions were homogeneous and iso intense on noncontrast T1-weighted images and hyperintense on T2-weighted i mages relative to the intervertebral disk. Homogeneous enhancement was seen in one of the two cases in which contrast-enhanced T1-weighted images were obtained. Purely extradural hemangiomas should be included in the differen tial diagnosis of lumbar extradural soft-tissue lesions. Features that may help to distinguish this entity from the more common extruded disk herniati on or neurogenic tumors are its homogeneous high signal intensity on T2-wei ghted images, ovoid shape, and lack of anatomic relationship with the adjac ent intervertebral disk or exiting nerve root.