Hemangioma / Hemangioblastoma

FACTS

Hemangiomas
  • peak 30-50 yrs, F > M
  • usually in VB
 
  • Hemangioblastoma
  • benign WHO grade I vascular lesions, do not undergo malignant degeneration.
  • most commonly in T >.C spine
  • have an exophytic component (most commonly along the dorsum of the cord)

HPI

Hemangioma
Hemangioblastoma
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VHL history (20-30% will have this)

PHYSICAL EXAM

  • universal spine-focused exam
IMAGING
Hemangioma
Hemangioblastoma
Axial images: polka dot sign
Longitudinal images: corduroy pattern
Ca2+ frequent
T2: mixed signal internally, hemosiderin ring is low T2 with blooming artifact
MRI: enhancing mural nodule with an associated cyst
Thoracic hemangio-blastoma demonstrating enhancing mural nodule w/ cyst
Thoracic hemangio-blastoma demonstrating enhancing mural nodule w/ cyst
 
Figure 1: Hemangioma: Honeycomb appearance on CT 2/2 thickened trabeculae

notion image

Figure 2:  Hemangioblastoma on angiogram - densely enhancing nidus with associated dilated arteries and prominent draining veins.
notion image
A/P
Hemangioma
Hemangioblastoma
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- before operating, should check UA (pheochromocytoma) and CTAP (VHL)
- EPO secreted in up to 10% of hemangioblastomas
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