Haemangiomas involving the spinal epidural space.

Introduction The purpose of the present communication is to collect as completely as possible the sources of information relating to a rare group of tumours of the spinal epidural space-those of blood-vessel origin**-and to record eight previously unpublished examples of this condition. It has been thought helpful to include in the study not only those tumours which arise primarily within the epidural tissue itself, but also those which extend into or invade the epidural space from an adjacent vertebra; for as the analysis of the known cases proceeded, it became obvious that there were intermediate stages between the purely epidural and the purely vertebral himangioma. The frequency of occurrence of any rare condition is always hard to estimate, and few writers have seen more than one or two epidural hiemangiomas. However, Rassmussen and others (1940) mention the occurrence ff. twenty-eight epidural tumours of blood-vessel origin among 557 intra-spinal neoplasms in the records ofthe Mayo Clinic; and Elsberg (1941) found four in his personal series of eighty-five epidural tumours of the spine. Purely epidural hmmangiomas seem almost always to occur in the thoracic spine. In histological structure they vary from cavernous himangiomas to the less mature hemangioendotheliomas and heemangioblastomas, some of which latter have shown a tendency to spread through the intervertebral foramina into the extraspinal tissues and to recur locally after removal. Reference to the literature has revealed fourteen authenticated examples of epidural hemangioma of mature type (Liebscher, 1901; Devic and Tolot, 1906; Beriel, 1922; Balado and Morea, 1927; Rand, 1927 (Case 1); Petit-Dutaillis and Christophe, 1931; Bucy, 1932; Mixter, 1932 (Case 6); Johnston, 1938; Elsberg, 1941 (2 cases); L6pez Ibor and Peraita, 1941; Wyburn-Mason, 1943 (Case 46); Grapiolo