Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma

A case report

Yoji Ogura, Koota Watanabe, Naobumi Hosogane, Takashi Tsuji, Ken Ishii, Masaya Nakamura, Yoshiaki Toyama, Kazuhiro Chiba, Morio Matsumoto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Cavernous hemangioma consists mainly of congenital vascular malformations present before birth and gradually increasing in size with skeletal growth. A small number of patients with cavernous hemangioma develop scoliosis, and surgical treatment for the scoliosis in such cases has not been reported to date. Here we report a 12-year-old male patient with severe progressive scoliosis due to a huge subcutaneous cavernous hemangioma, who underwent posterior correction and fusion surgery. Upon referral to our department, radiographs revealed a scoliosis of 85° at T6-L1 and a kyphosis of 58° at T4-T10. CT and MR images revealed a huge hemangioma extending from the subcutaneous region to the paraspinal muscles and the retroperitoneal space and invading the spinal canal. Posterior correction and fusion surgery using pedicle screws between T2 and L3 were performed. Massive hemorrhage from the hemangioma occurred during the surgery, with intraoperative blood loss reaching 2800 ml. The scoliosis was corrected to 59°, and the kyphosis to 45° after surgery. Seven hours after surgery, the patient suffered from hypovolemic shock and disseminated intravascular coagulation due to postoperative hemorrhage from the hemangioma. The patient developed sensory and conduction aphasia caused by cerebral hypoxia during the shock on the day of the surgery. At present, two years after the surgery, although the patient has completely recovered from the aphasia. This case illustrates that, in correction surgery for scoliosis due to huge subcutaneous cavernous hemangioma, intraoperative and postoperative intensive care for hemodynamics should be performed, since massive hemorrhage can occur during the postoperative period as well as the intraoperative period.

Original languageEnglish
Article number3
JournalScoliosis
Volume6
Issue number1
DOIs
Publication statusPublished - 2011 Mar 17

Fingerprint

Cavernous Hemangioma
Scoliosis
Hemangioma
Kyphosis
Shock
Conduction Aphasia
Intraoperative Period
Wernicke Aphasia
Retroperitoneal Space
Hemorrhage
Paraspinal Muscles
Brain Hypoxia
Postoperative Hemorrhage
Vascular Malformations
Spinal Canal
Postoperative Care
Disseminated Intravascular Coagulation
Aphasia
Critical Care
Ambulatory Surgical Procedures

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma : A case report. / Ogura, Yoji; Watanabe, Koota; Hosogane, Naobumi; Tsuji, Takashi; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Chiba, Kazuhiro; Matsumoto, Morio.

In: Scoliosis, Vol. 6, No. 1, 3, 17.03.2011.

Research output: Contribution to journalArticle

Ogura, Yoji ; Watanabe, Koota ; Hosogane, Naobumi ; Tsuji, Takashi ; Ishii, Ken ; Nakamura, Masaya ; Toyama, Yoshiaki ; Chiba, Kazuhiro ; Matsumoto, Morio. / Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma : A case report. In: Scoliosis. 2011 ; Vol. 6, No. 1.
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