Hemangioma is often on an MRI report of the lumbar or thoracic spine. I spend time in the office with patients going over the concept of a hemangioma. It can be intimidating to read your own MRI report and see blood vessel tumor in the bold print.
I spoke with a patient this week who had lumbar degenerative disc disease. He asked me about the “tumor” he read in his MRI report. We spent time going over a hemangioma and he left the office relieved. So what is a hemangioma and do you need to treat it? Here are 4 key points to know.
- What is a hemangioma? A hemangioma is a benign blood vessel tumor. Approximately 1 in 10 people have hemangiomas. When a hemangioma is in a vertebral body, it tends to be in the thoracic spine. Hemangiomas can occur in the cervical and lumbar spine as well. It is thought to occur more frequently in females and multiple hemangiomas can be seen in up to 1 in 3 people.
- Why are hemangiomas found in vertebral bodies? The vertebrae has a rich blood supply. Because of this fact, blood vessel tumors can occur. This is similar to the reason why a metastasis to the spine occurs in cancer. Unlike cancer, 99% of hemangiomas are not worrisome and are incidental findings.
- When is a hemangioma in a vertebral body a problem? When a hemangioma begins to grow it can cause back pain. If the hemangioma is near the spinal cord, it’s growth can cause spinal cord dysfunction, or myelopathy, to develop. It is important to reiterate that less than 1% of hemangiomas grow to the point where intervention is required.
- What is the treatment for hemangiomas that grow? There are several types of treatment for a hemangioma. The first is radiation therapy. This is where x-ray beams are directed to the vertebral body where the hemangioma is located. This can be effective but can weaken the vertebral body leading to a compression fracture. This may require a kyphoplasty to stabilize the fracture. Kyphoplasty can also be used as an initial step for aggressive hemangiomas. Surgical excision of a hemangioma is a significant operation where a corpectomy is typically performed. This is where the vertebral body is removed surgically. Prior to the surgery an attempt may be made to embolize the hemangioma. This is a procedure where the blood supply is cut off from the blood vessel tumor.
If you have a hemangioma mentioned on an MRI report, take comfort in knowing that is likely an incidental finding. An MRI or CT scan will pick up imperfections in all of us. It is important to follow-up with a doctor you have confidence in to make sure it is incidental. If a hemangioma becomes aggressive, there are good options out there. What thoughts or comments do you have? Have you had a hemangioma on your MRI report? I would like to hear from you.