Abstract
A woman in her early 50s presented with an 8-month history of bilateral lower limb weakness and a 3-month history of unsteady gait. Imaging revealed a dumbbell-shaped mass near T1-T3, initially diagnosed as a schwannoma. Intraoperatively, a highly vascular dark red tumor was discovered, and only partial resection was performed due to bleeding risk. Pathology confirmed an epidural cavernous hemangioma. Symptoms had significantly improved at the 2-month follow-up without recurrence. This case highlights the importance of comprehensive preoperative imaging to prevent misdiagnosis and optimize surgical planning for atypically located tumors.