An unusual case of spinal cord compression secondary to iliopsoas cavernous hemangioma: A case report and literature review.

Rationale: We report on a 16-year-old woman who had a history of a vascular malformation involving the left iliopsoas muscle and underwent multiple sclerotherapy sessions over the preceding 5 years without clinical improvement.

Patient Concerns: Ten days before admission, the patient experienced the acute onset of paraparesis. Computed tomography and magnetic resonance imaging revealed a large vascular malformation, measured 90 × 100 × 100 mm, situated at the T12 to L4 vertebral levels within the left iliopsoas muscle, exerted significant compression on the conus medullaris and cauda equina.

Diagnoses: Preoperative diagnosis of a vascular malformation in the left iliopsoas muscle compressed the spinal cord.

Interventions: She underwent angiography and embolization of hemangioma, followed by 2 surgeries, the initial resection of intraspinal hemangioma with concurrent spinal cord decompression, and the subsequent resection of the iliopsoas hemangioma. This staged strategy was deemed a safe and efficacious approach. Intraoperative findings and subsequent histopathological analysis concluded the diagnosis of iliopsoas cavernous hemangioma.

Outcomes: After 8 months of follow-up, the patient recovered completely.

Lessons: To the best of our knowledge, this is the first report of cavernous hemangioma in the iliopsoas muscle compressing the spinal cord. This study aims to highlight the diagnostic complexities, the chosen therapeutic strategy, and the role of pathological evaluation in such rare entities.