Pure epidural cavernous hemangiomas of the spinal canal are extremely rare. We describe a case of lumbar epidural hemangioma suspected as a lumbar radiculopathy in a 78-year-old man who presented with a 1-month history of the low back pain and right lower extremity pain. An electrodiagnostic study demonstrated right L4 radiculopathy. Noncontrast magnetic resonance image (MRI) showed a nodular lesion suggestive of a sequestered disc with compression of right L4 root, most likely. Contrast MRI revealed an oval enhancing nodular lesion, 1.4×0.5 cm in size, indicative of a hemangioma in right anterior epidural space at L4 level. He underwent an excisional biopsy. The pathological diagnosis was cavernous hemangioma. His symptoms resolved after the operation. Spinal epidural cavernous hemangioma should be considered as a cause of a lumbar radiculopathy. (J Korean Acad Rehab Med 2010; 34: 238-241)
