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Table of Contents    
Year : 2013  |  Volume : 61  |  Issue : 1  |  Page : 89-90

Masson's hemangioma: A very rare cause of spinal cord compression

1 Department of Neurology, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
2 Department of Pathology, Rajaei Hospital, Qazvin University of Medical Sciences, Qazvin, Iran

Date of Submission17-Feb-2012
Date of Decision21-Oct-2012
Date of Acceptance01-Nov-2012
Date of Web Publication4-Mar-2013

Correspondence Address:
Mohammad Sayadnasiri
Department of Neurology, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.108032

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How to cite this article:
Mozhdehipanah H, Samiei F, Sayadnasiri M. Masson's hemangioma: A very rare cause of spinal cord compression . Neurol India 2013;61:89-90

How to cite this URL:
Mozhdehipanah H, Samiei F, Sayadnasiri M. Masson's hemangioma: A very rare cause of spinal cord compression . Neurol India [serial online] 2013 [cited 2021 Jan 24];61:89-90. Available from:


A 58-year-old male, a known case of renal transplantation on immunosuppressive therapy since 4 years, presented with gait problem of one month duration and recent onset of lower extremity paresthesias. Neurologic examination showed mild asymmetric spastic paraparesis, hyperreflexia, and bilateral up-going plantar response. The sensory level was at T6-8 level. Dorsal spine magnetic resonance imaging (MRI) showed a well circumscribed extradural mass (3 × 1 cm) extended from T4 to T6 level and vertebral hemangioma (VH) involving T4 and T5 vertebral bodies [Figure 1]a. Patient was scheduled for decompression surgery and specimen was sent for tissue diagnosis. Histopathology showed intravascular anastomosing vascular channels and papillary formation with hyaline core [Figure 1]b. These structures were covered by plump endothelial cells and in some areas, residual thrombi were evident [Figure 1]c. There was no cellular atypia, necrosis, and mitotic activity. The histological features were suggestive of an intra-vascular papillary endothelial hyperplasia (IPEH) or Masson's hemangioma. Following surgery, the patient had gradual improvement in the neurologic deficits. At 6-month follow-up, he is symptom-free with no complications.
Figure 1: (a) Sagital T2-weighted magnetic resonance images showing a hyperintense extra-dural mass compressing the spinal cord at T4 to T6 level. There are also vertebral hemangiomas in T4 and T5 vertebral bodies. (b) Histological features (hematoxylin and eosin stain): Anastomosing vascular channels confined to the vessel lumen associated with neural bundles. (c) Intravascular proliferation of bland-looking plump endothelial cells associated with residual organized thrombus

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IPEH, a benign condition, originates from an organizing vascular thrombosis with reactive endothelial proliferation and mainly occurs in extraneural tissues especially in skin and soft tissue. [1] Involvement of spinal cord is extremely rare. [2],[3],[4],[5]

All the four reported patients including our patient were male and age ranged between 16 and 58 years and the location of the lesion was epidural, thoracic in three and thoraco-lumbar in one. Three patients presented with paraparesis and one with cauda equina syndrome. In all these patients including our patient, surgical excision of the lesion was associated with favorable outcome. [2],[3],[4],[5] In our patient, there were VH in two vertebral bodies adjacent to the level of cord compression. Most often VHs are incidental neuroimaging finding. It is quite possible that in our patient there might be causal relation between VHs and Masson's hemangioma. Rarely, VHs can have an aggressive course and lead to hemorrhage in the epidural space of spinal canal. In our patient, there might have been a bleed in the spinal canal with subsequent formation of an organized thrombus transforming into Masson's hemangioma and became symptomatic.

 » References Top

1.Clearkin KP, Enzinger FM. Intravascular papillary endothelial hyperplasia. Arch Pathol Lab Med 1976;100:441-4.  Back to cited text no. 1
2.Ali SZ, Farmer PM, Black K, Rosenthal A. Masson's hemangioma of spinal meninges causing cord compression with paraplegia. Ann Clin Lab Sci 1994;24:371-5.  Back to cited text no. 2
3.Porter DG, Martin AJ, Mallucci CL, Makunura CN, Sabin HI. Spinal cord compression due to Masson's vegetant intravascular hemangioendothelioma. Case report. J Neurosurg 1995;82:125-7.  Back to cited text no. 3
4.Taricco MA, Vieira JO Jr, Machado AG, Ito FY. Intravascular papillary endothelial hyperplasia causing cauda equina compression: Case report. Neurosurgery 1999;45:1478-80.  Back to cited text no. 4
5.Lanotte M, Molinaro L, Crudo V, Filosso PL, Crasto SG, Roncaroli F, et al. Spinal cord compression due to an extra-dural intra-vascular papillary endothelial hyperplasia of the thoracic spine. Acta Neurochir (Wien) 2010;152:877-80.  Back to cited text no. 5


  [Figure 1]

This article has been cited by
1 Masson Hemangioma—An Unusual Cause of Thoracic Compressive Myelopathy
Bikash Ranjan Behera,Rabi Narayan Panda,Sanjib Mishra,Manmath Kumar Dhir
World Neurosurgery. 2017; 98: 876.e9
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