Aggressive hemangioma of the spine in a pregnant female: a case report and literature review
İsmail Demirkale1, Federico De Iure2, Silvia Terzi3, Alessandro Gasbarrini3
1Department of Orthopedics and Traumatology, Keçiören Training and Research Hospital, Ankara, Turkey
2Ospedale Maggiore, Bologna, Italy
3Instituto Ortopedico Rizzoli, Bologna, Italy
Keywords: Hemangioma; paraplegia; pregnancy; spine.
Abstract
Type and timing of treatment for symptomatic hemangiomas in pregnant females are challenging due to fetus survival and conflicts in neurological recovery. In this article, we report a 40-year-old female patient at pregnancy week 23 with a complicated hemangioma at T1 level. Physical examination revealed an incomplete spastic paraplegia. Patient did not accept any surgery due to child’s death risk. Patient was started corticoid treatment and no more weight bearing was allowed. At the 28th week of pregnancy, the patient underwent cesarean section immediately followed by selective arterial embolization, decompression, fixation, and radiotherapy. At two-year follow-up, the patient was pain free, without any signs of local recurrence and with complete neurological recovery. A multidisciplinary approach is mandatory to save the life of the fetus without damaging the spinal cord functions of the mother.