Radiology Teaching Files > Case 7747067

Contributed by: patricia burrows, Radiologist, Children's Hospital Boston, Massachusetts, USA.
Patient: 17 year old male
History: 17 year old male with several year history of severe back and neck pain, who has been followed for a hemangioma of the T11 vertebral body. The most recent MRI indicated that the lesion had grown and the vertebral body had lost a small degree of height.

Fig. 1: MRI dated 11/11/1998 Patient 16 y.o. Pre-Sclero

Fig. 2: MRI dated 11/11/1998 Patient 16 y.o. Pre-Sclero

Fig. 3: MRI dated 11/11/1998 Patient 16 y.o. Pre-Sclero

Fig. 4: MRI dated 11/11/1998 Patient 16 y.o. Pre-Sclero

Fig. 5: Angio/Sclero dated 02/02/2000 Patient 17 y.o.


ANGIOGRAPHIC FINDINGS: The contrast injections outline a fine pattern of interconnecting linear vascular channels throughout the right side of the body of T11. Within the pedicle, there is a confluent vascular space corresponding to the MRI. There is drainage into both adjacent T11-T12 segmental vein and the adjacent epidural plexus.

Following the procedure, the right side of the vertebral body was opacified with the alcohol.

SUMMARY: Vascular malformation of the body and pedicle of T11. Technically successful ethanol sclerotherapy.

CT SPINE - 3/2/01:

T11 VERTEBRA: There is abnormal linear and confluent lucency with areas of central trabeculation, in a somewhat corduroy type pattern involving the T11 vertebral body, right pars interarticularis, transverse process and right superior articular facet, not significantly changed in appearance since 10/2/00. Several coils are noted within the right paraspinal soft tissues and within the T11 vertebral body, unchanged. Of note, is slight interval loss of the T11 vertebral body, with mild depression of predominantly the right aspect of the superior endplate of T11, since 10/2/00. There is no evidence of abnormal epidural collection.

IMPRESSION: Slight interval depression of the superior endplate of the T11 vertebral body.

Diagnosis: Vascular malformation involving the right aspect of the T11 vertebral body supplied by two separate branches of the right T11 intercostal artery and the superior branch.  Clinical diagnosis is vertabral hemangioma. 
The patient was treated with ethanol embolization/sclerotherapy X2 (11/98 and 02/00) with moderate decrease in back and neck pain.
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Additional Details:

Case Number: 7747067Last Updated: 03-15-2007
Anatomy: Spine and Peripheral Nervous System   Pathology: Vascular
Modality: CT, MR, AngiographyAccess Level: Readable by all users
Keywords: sclerotherapy

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