A rare invasive hemangioma in cauda equina

Purpose Typical hemangioma of cauda equina with relative clear margin has been described in some case reports, but atypical hemangioma with invasion, infiltration, and augmentation of all nerve roots in the cauda equina area has never been reported. In this paper, we reported a rare case with invasive hemangioma in cauda equina, and analyzed its radiological appearance and treatment. Methods We described an atypical case of hemangioma, which was revealed by MR and intraoperative photograph without clear margin and confirmed by histopathologic diagnosis. Results The patient was received radiotherapy (5400 cGy/25f/5w) and continued to be clinically in good condition with follow-up MR after 24 months without further surgery. Conclusions Surgery may be the first management modality for hemangiomas with severe or progressive neurologic deficits, and radiotherapy may be an alternative therapy to treat hemangiomas according to accurate histopathologic diagnosis.