IS Case 320: Spine hemangioma with extraosseous extension

Malin Cesarz, MD

Imaging Sciences URMC 2009
Publication Date: 2009-09-14


Patient is a 43-year-old woman with neck pain, numbness and weakness of the right arm. There was no known injury.


Imaging Findings: See below.


Spine hemangioma with extraosseous extension


While hemangiomas in the spine are usually asymptomatic, they can cause symptoms. The hemangiomas with extraosseous extension are more likely to cause neurologic problems. Other hemangiomas which are symptomatic are associated with vertebral body collapse.

The prevalence of vertebral hemangiomas is 11% in large autopsy series. They comprise almost 30% of all skeletal hemangiomas and are multiple in up to 30% of cases.

Imaging characteristics:

CT: Fine or coarse trabeculations.

MRI: Hyperintensity on T1 and T2 usually due to the fatty content. More vascular hemangiomas may have lower intensity on T1 weighted images. If there is an extraosseous component, it may have intermediate intensity on T1. +contrast enhancement

Due to neurologic symptoms, the patient in this case received radiation with resultant decrease in mass effect from hemangioma.


  1. Adam A, Dixon AK, Eds. Grainger & Allison's Diagnostic Radiology, 5th ed., Churchill Livingston, 2008.
  2. Donthineni R. Diagnosis and staging of spine tumors. Orthop Clin North Am. 2009 Jan;40(1):1-7, v. PMID: 19064051

2 images