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Spine and Back Health

Atypical Vertebra Hemangioma

08/17/2011

Question:

In 2008 I was diagnosed with the hemangioma and now a repeat MRI showed the hemangioma and a metastatic lesion. This is at the l4 level. The MRI stated they did not see any cortical destruction or vertebral collapse. My question is, should I be concerned about this and or maybe get a second opinion, because my pain management doctor does not seem too concerned?

Answer:

Hello, thank you for your question. You definitely need to get a very careful clarification of the terminology you have described here. A hemangioma is a simple, benign abnormality of the vertebral bone. The term "metastatic lesion" basically refers to cancer, so if you really mean that they just found another hemangioma somewhere else in the spine please don't use the term "metastatic". If this really is thought to be a metastatic lesion you need to be evaluated immediately for this. I doubt any halfway competent physician would be "not too concerned" if there really is a metastatic lesion. Please make sure someone clarifies this point for you so you know whether to worry or not. You definitely need to ask an MD about this, provide them with the actual radiologist's report and possibly the MRI films themselves. Good luck.

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University