Dear Editor, The occurrence of purely epidural capillary hemangioma is exceedingly rare, with only four reported cases in the English literature [3, 6, 7, 12]. Because of the excessive vascularity of capillary hemangioma, en bloc removal and/ or preoperative embolization of feeding arteries of the lesion should be recommended [8]. However, as consensus magnetic resonance imaging (MRI) study and specific features regarding capillary hemangiomas are not yet available, they are usually misdiagnosed preoperatively [3, 7]. Here, we report a case of a capillary hemangioma of the thoracic epidural region, with particular emphasis on relevant radiological features that could aid in the differential diagnosis of the lesion and therefore allow appropriate management. A 59-year-old woman presented with a 1-year history of back pain and right intercostal neuralgia. Physical examination revealed proprioceptive ataxia that caused difficulties with walking, decrease of the motor strength in lower limbs, and brisk osteotendinous reflexes. MRI (Fig. 1a–d) demonstrated a well-circumscribed, probably epidural, avidly enhancing mass that extended from T5 to T7, with intrathoracic extension through the right foramen at T6–T7, abutting the adjacent pleura. Signal void areas in and around the lesion indicated the presence of draining veins, suggesting the differential diagnosis of vascular pathologies such as hemangioma or hemangioblastoma. A T5–T7 laminectomy was performed with removal of the right T6–T7 facet joint and corresponding costotransverse joint to expose the whole lesion. The spongy, redpurple hemorrhagic epidural mass (Fig. 1e) was clearly originating from the T6 proximal nerve root, easily cleaved from the dura, and excised en bloc (Fig. 1f) as planned preoperatively. Many small feeder branches and vessels draining into the epidural venous system were sacrificed. The estimated intraoperative blood loss was 2 l. Pathologic examination showed innumerable thin-walled capillary vessels, lined by flattened endothelium and embedded within a loose connective tissue stroma (Fig. 1g) consistent with a capillary hemangioma. Unlike cavernous hemangiomas, the lesion was devoid of abnormally hyalinized vascular channels, thromboses, calcifications, or surrounding deposition of hemosiderin pigment. Capillary hemangiomas are considered hamartomatous proliferations of vascular endothelial cells [2]. They are classified by the predominant type of vascular channel (capillary, cavernous, arteriovenous, or venous) observed at histological examination. Epidural hemangiomas are actually considered to be an extension of vertebral lesions [4, 5]. The occurrence of purely spinal epidural hemangiomas is exceedingly rare, and most of the reported cases were a cavernous type [4, 5, 9]. However, as histological differentiation between capillary hemangioma and cavernous hemangioma is not always unequivocal, some epidural capillary hemangiomas may have been published under the designation of cavernous F. Vassal : C. Nuti Department of Neurosurgery, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France