Imaging Features of Spinal Hemangioendothelioma Simulating Tuberculous Spondylitis: A Case Report

Abstract Background The clinical manifestations of spinal tuberculosis and spinal metastases are often nonspecific. Although imaging features of these two conditions are usually characteristic, atypical presentations may cause diagnostic confusion and deserve particular attention. Case presentation We report the case of a 59-year-old man who presented with a 1-year history of chest and back pain that had worsened over the past month. His imaging findings were highly suggestive of spinal tuberculosis; however, histopathological examination of the surgically resected specimen confirmed a diagnosis of spinal hemangioendothelioma. We initially misdiagnosed the lesion as tuberculosis based on imaging alone. Conclusions Distinguishing spinal tuberculosis from spinal tumors on clinical grounds remains difficult. Given the limitations of medical history and imaging in the differential diagnosis, this case underscores the critical importance of pathological examination for accurate diagnosis and appropriate therapeutic decisionmaking in spinal hemangioendothelioma.