Cavernoma of the cauda equina mimicking schwannoma: A case report

Abstract

Cavernous malformations (CMs), also known as cavernomas or cavernous hemangiomas, are vascular lesions characterized by clusters of abnormally dilated blood vessels resembling a mulberry. In this report, we present the case of a 40-year-old man who presented with a one-year history of back pain radiating into both legs, with a preference for the left leg. An MRI initially suggested a schwannoma at the T12-L1 vertebral level, with a differential diagnosis that included meningioma—2 common intradural-extramedullary spinal tumors— with distinct management and prognostic implications. However, despite imaging findings consistent with a schwannoma, the final pathology revealed an intradural extramedullary (IDEM) cavernous hemangioma in the thoracolumbar region. Although cavernous hemangiomas are very rare in the spinal region, our case underscores the importance of considering them in the differential diagnosis of IDEMs in the thoracolumbar area.