Spinal Hemangioma

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Spinal Hemangioma

Question:

I have a hemangioma on my spine. Does this pose any threat at all?

Answer:

If there is no pain or other symptoms, a spinal hemangioma is generally of no medical consequence.

A hemangioma is an abnormal collection of blood vessels that may be present in a number of tissues, including bone, skin and muscle. Hemangiomas of the spine are common: In one autopsy study, 10% of adults had at least one spinal hemangioma.

Most hemangiomas of the spine cause no symptoms. They are detected by X-ray or other imaging tests (such as MRI) used to evaluate unrelated symptoms. The cause is unknown. They may be present at any age. Sometimes a person has multiple hemangiomas, a condition called hemangiomatosis.

Perhaps the biggest risk of a spinal hemangioma is that it may have an appearance of tumor or infection. In such cases, a biopsy may be attempted to establish the diagnosis. Because hemangiomas are full of blood vessels, a biopsy may be complicated by excessive bleeding. When imaging tests strongly suggests the presence of a spinal hemangioma, and there are no symptoms clearly related to it, no biopsy is necessary.

Treating a spinal hemangioma is rarely necessary. In the minority of cases in which symptoms are significant or when the hemangioma compresses nerves or the spinal cord, surgery to completely remove the hemangioma may be recommended. This is actually less risky than a biopsy because the surgeon cuts around rather than through the hemangioma.

Other options are radiation therapy or interruption of the blood supply to the hemangioma by a procedure called "selective arterial embolization."

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Last updated:	July 20, 2009