Concomitant Thoracic Spinal Hemangioma and Dural Arteriovenous Fistula: Case Description and Technical Note

Background and Clinical Significance: Coexistence of spinal hemangiomas and dural arteriovenous fistula (SDAVF) is uncommon. Unclear imaging and progressive neurological impairment require early surgical management. Case Presentation: A 76-year-old woman presented with progressive thoracolumbar pain and bladder dysfunction. Magnetic resonance imaging (MRI) of the thoracic spine revealed a round-shape expansive lesion at D11 with spinal cord edema and homogeneous contrast enhancement. Intraoperatively a vascular malformation resembling a dural arteriovenous fistula (SDAVF) was found in association and histological examination confirmed the diagnosis of hemangioma. Conclusions: this case underscores the importance of thorough imaging evaluation and prompt surgical management in patients presenting with neurological impairment ad a suspicion of spinal hemangioma: this case may provide awareness of potentially associated SDAVF, unrecognized at pre-operative imaging, and technical insights during surgery.