1
|
Sop FYL, Benato A, Izoudine BK, Khouri K, Marangon A, Fraschetti F, Lonjon N, Ferraresi S. Spinal lymphangiomas: Case-based review of a chameleonic disease entity. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2024; 15:4-14. [PMID: 38644908 PMCID: PMC11029117 DOI: 10.4103/jcvjs.jcvjs_125_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/31/2023] [Indexed: 04/23/2024] Open
Abstract
Purpose Lymphangiomas are benign hamartomas in the spectrum of lymphatic malformations, exhibiting multifaceted clinical features. Spinal involvement is exceedingly rare, with only 35 cases reported to date. Both due to their rarity and chameleonic radiologic features, spinal lymphangiomas (SLs) are usually misdiagnosed; postoperatively, surgeons are thus confronted with an unexpected histopathological diagnosis with sparse pertinent literature and no treatment guidelines available. Methods Here, we report the case of a 67-year-old female who underwent surgery for a T6-T7 epidural SL with transforaminal extension, manifesting with spastic paraparesis. Then, we present the results of the first systematic review of the literature on this subject, delineating the clinical and imaging features and the therapeutic implications of this rare disease entity. Results Our patient was treated with T6-T7 hemilaminectomy and resection of the epidural mass, with complete recovery of her neurological picture. No recurrence was evident at 18 months. In the literature, 35 cases of SL were reported that can be classified as vertebral SL (n = 18), epidural SL (n = 10), intradural SL (n = 3), or intrathoracic lymphangiomas with secondary spinal involvement (n = 4). Specific treatment strategies (both surgical and nonsurgical) were adopted in relation to each of these categories. Conclusion Gathering knowledge about SL is fundamental to promote both correct preoperative identification and appropriate perioperative management of this rare disease entity. By reviewing the literature and discussing an exemplary case, we delineate a framework that can guide surgeons facing such an unfamiliar diagnosis.
Collapse
Affiliation(s)
- François Yves Legninda Sop
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
- Department of Neurosurgery, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
| | - Alberto Benato
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Kifah Khouri
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
| | - Anna Marangon
- Department of Anesthesiology and Critical Care Medicine, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
| | - Flavia Fraschetti
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicolas Lonjon
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
| | - Stefano Ferraresi
- Department of Neurosurgery, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
| |
Collapse
|
2
|
Sarıkaya C, Ramazanoğlu AF, Yaltırık CK, Etli MU, Önen MR, Naderi S. Short-Term Results of Simpson Grade 2 Resection in Spinal Meningiomas. World Neurosurg 2023; 171:e792-e795. [PMID: 36587895 DOI: 10.1016/j.wneu.2022.12.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Spinal meningiomas are benign and slow-growing intradural tumors. Surgery is the choice of treatment. In this retrospective study, results of minimally invasive Simpson grade 2 resection and its impact on recurrence in 44 spinal meningiomas are reviewed. METHODS Clinical data of 44 cases who underwent surgery for spinal meningiomas between 2010 and 2020 have been reviewed retrospectively. Demographics, preoperative and postoperative clinical states, pathologic type, location of the meningioma relative to the spinal cord, resection amount of the tumor according to Simpson's grading scale, postoperative complications, recurrence rate, and correlation between preoperative and intraoperative data and recurrence were analyzed. RESULTS The tumor was located in the thoracic spine in 31 cases, in the cervical spine in 12 cases, and in the lumbar spine in one case. Dural attachment of tumor was ventral to the spinal cord in 15 cases, lateral to the spinal cord in 15 cases, and posterior to the spinal cord in 14 cases. All cases underwent microsurgical Simpson grade 2 resection. Two cases were recurrent and reoperated. Recurrences were observed in cases younger than 18 years old, in cervical spines and in cases with long dural tails. CONCLUSIONS Simpson grade 2 resection is safe and effective in spinal meningiomas. Patients younger than 18 year old, and those with cervical location and long dural tail may be under risk of recurrence after Simpson grade 2 resection.
Collapse
Affiliation(s)
- Caner Sarıkaya
- Department of Neurosurgery, Sivas State Hospital, Sivas, Turkey.
| | - Ali Fatih Ramazanoğlu
- Department of Neurosurgery, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Cumhur Kaan Yaltırık
- Department of Neurosurgery, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Umut Etli
- Department of Neurosurgery, Siverek State Hospital, Şanlıurfa, Turkey
| | - Mehmet Reşid Önen
- Department of Neurosurgery, VM Medical Park Maltepe Hospital, İstanbul, Turkey
| | - Sait Naderi
- Department of Neurosurgery, İstanbul Brain and Spine Center, İstanbul, Turkey
| |
Collapse
|
3
|
D'Souza RS, Woods CD, Lee D, Kissoon N, Bendel M. Delayed Cutaneous Fluid Leakage after Fluoroscopic-Guided Epidural Steroid Injection. PAIN MEDICINE 2021; 22:3092-3095. [PMID: 33755154 DOI: 10.1093/pm/pnab108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Charonn D Woods
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Daewoong Lee
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Narayan Kissoon
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Markus Bendel
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| |
Collapse
|
4
|
Payne C, Gigliotti MJ, Castellvi A, Yu A. Rare case of cystic hygroma in the epidural space resulting in multilevel spinal cord compression. BMJ Case Rep 2019; 12:12/8/e230326. [PMID: 31466987 DOI: 10.1136/bcr-2019-230326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Lymphangioma, or cystic hygroma, involving the epidural space and spinal soft tissue, is a rare benign lesion consisting of an abnormal collection of lymphatic tissue isolated from the normal lymphatic system. This case report is the most extensive case of cystic hygroma involving the spine reported in the literature. A 23-year-old man with a history of cystic hygromas of the neck and thorax presented with bilateral upper and lower extremity weakness that progressively worsened over 3 months. A left hemilaminectomy from C4 to T5 with endoscopic exploration and cyst drainage was performed. At last follow-up, the patient was ambulating and returned to work. Aggressive decompression of mass lesions resulting in myelopathy, such as the spinal cystic hygromas, resulted in improved motor function as well as overall function status.
Collapse
Affiliation(s)
- Christopher Payne
- Allegheny General Hospital - Western Pennsylvania Hospital Medical Education Consortium, Pittsburgh, Pennsylvania, USA
| | - Michael J Gigliotti
- Allegheny General Hospital - Western Pennsylvania Hospital Medical Education Consortium, Pittsburgh, Pennsylvania, USA
| | - Alejandro Castellvi
- Allegheny General Hospital - Western Pennsylvania Hospital Medical Education Consortium, Pittsburgh, Pennsylvania, USA
| | - Alexander Yu
- Allegheny General Hospital - Western Pennsylvania Hospital Medical Education Consortium, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
5
|
Pojskić M, Zbytek B, Mutrie CJ, Arnautović KI. SPINAL DUMBBELL EPIDURAL HEMANGIOMA: TWO STAGE/SAME SITTING/SAME POSITION POSTERIOR MICROSURGICAL AND TRANSTHORACIC ENDOSCOPIC RESECTION - CASE REPORT AND REVIEW OF THE LITERATURE. Acta Clin Croat 2018; 57:797-808. [PMID: 31168222 PMCID: PMC6544093 DOI: 10.20471/acc.2018.57.04.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/20/2018] [Indexed: 12/16/2022] Open
Abstract
- Spinal dumbbell tumors are defined by a narrowing at the point where they penetrate the intervertebral foramina or dura mater, assuming an hourglass or dumbbell shape. Dumbbell-shaped spinal hemangiomas are extremely rare. We describe a dumbbell spinal tumor (epidural cavernous hemangioma) resected by a 2-stage single-sitting combined approach. We also conduct a substantial literature review of the subject. We present a case of a 78-year-old male who was found to have a homogeneously enhancing, dumbbell-shaped, intraspinal, extradural tumor mass extending into the left chest cavity. The tumor was resected with a single-sitting 2-stage posterior technique: a microsurgical approach, followed by endoscopic resection via a thoracoscopic approach. There are several reports in the literature on the combined approach for dumbbell tumors of the spinal cord. Our case is the first to describe 2-stage combined surgery in 1 sitting for dumbbell hemangioma with the patient in the lateral decubitus position for the thoracoscopic part of the surgery; and the use of a fat pad, which was applied in the neuroforamen via the posterior route, as a marker for resection during the transthoracic procedure.
Collapse
Affiliation(s)
- Mirza Pojskić
- 1Department of Neurosurgery, University of Marburg, Marburg, Germany; 2Pathology Group of Midsouth, Memphis, TN, USA; 3Baptist Memorial Group Thoracic Surgery, Memphis, TN, USA; 4Semmes Murphey Neurologic & Spine Institute and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Blazej Zbytek
- 1Department of Neurosurgery, University of Marburg, Marburg, Germany; 2Pathology Group of Midsouth, Memphis, TN, USA; 3Baptist Memorial Group Thoracic Surgery, Memphis, TN, USA; 4Semmes Murphey Neurologic & Spine Institute and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Christopher J Mutrie
- 1Department of Neurosurgery, University of Marburg, Marburg, Germany; 2Pathology Group of Midsouth, Memphis, TN, USA; 3Baptist Memorial Group Thoracic Surgery, Memphis, TN, USA; 4Semmes Murphey Neurologic & Spine Institute and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kenan I Arnautović
- 1Department of Neurosurgery, University of Marburg, Marburg, Germany; 2Pathology Group of Midsouth, Memphis, TN, USA; 3Baptist Memorial Group Thoracic Surgery, Memphis, TN, USA; 4Semmes Murphey Neurologic & Spine Institute and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| |
Collapse
|
6
|
Kerolus MG, Patil J, Kurian A, Sani S. Intradural cavernous lymphangioma of the thoracic spine: case report, technical considerations, and review of the literature. Spine J 2016; 16:e561-5. [PMID: 26970599 DOI: 10.1016/j.spinee.2016.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 02/11/2016] [Accepted: 03/04/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Cavernous lymphangioma is a rare slow-growing tumor that can cause neurologic compromise when it involves the central nervous system. Involvement of the spinal column is rare but may involve the osseous structures or the epidural space of the spinal column. PURPOSE We report the first case of an intradural, extramedullary cavernous lymphangioma involving the thoracic spinal cord. METHODS An 83-year-old woman presented with progressive gait ataxia, bilateral lower extremity weakness, and a band-like sensation in the middle and lower thoracic dermatomes. Magnetic resonance imaging of the thoracic spinal cord revealed hyperintensity on T2 and enhancement of an intradural cystic mass along the dorsal aspect of the T5-T8 levels with significant compression of the spinal cord. RESULTS Complete surgical resection was difficult owing to the adherence of the tumor to the pial surface and microvasculature of the thoracic spinal cord. Recurrence of the mass was ultimately treated with cystic fluid diversion into the peritoneum. At her follow-up visit after 28 months, the patient was able to ambulate with minimal assistance. A comparative literature review is presented. There are no reports of intradural thoracic spinal cord involvement in the literature. CONCLUSIONS Intradural cavernous lymphangioma of the spine poses a unique surgical challenge for complete resection. Cystic fluid diversion appears to be a viable treatment option with lasting benefit if complete resection is not achieved.
Collapse
Affiliation(s)
- Mena G Kerolus
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
| | - Jyothi Patil
- Department of Pathology, Rush-Copley Medical Center, Aurora, IL, USA
| | - Abraham Kurian
- Department of Pathology, Rush-Copley Medical Center, Aurora, IL, USA
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
| |
Collapse
|
7
|
Surgical Treatment of Large Abdominally Involved Primary Dumbbell Tumor in the Lumbar Region. ACTA ACUST UNITED AC 2014; 27:E268-75. [DOI: 10.1097/bsd.0000000000000108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Hekmatnia A, Ghazavi A, Aminmansour B, Mahzouni P. A case of chondrosarcoma that primarily developed in the cervical spine. IRANIAN JOURNAL OF RADIOLOGY 2012; 9:57-9. [PMID: 23329963 PMCID: PMC3522341 DOI: 10.5812/iranjradiol.6344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Revised: 10/05/2011] [Accepted: 11/28/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Ali Hekmatnia
- Department of Radiology, Image Processing and Signal Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Ghazavi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
- Corresponding author: Amirhossein Ghazavi, Department of Radiology, Isfahan University of Medical Sciences, Mohtasham Kashani St., Alley No: 27, No: 84, Isfahan, Iran. Tel.: +98-9133089543, Fax: +98-3116282697, E-mail:
| | - Bahram Aminmansour
- Department of Neurosurgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Mahzouni
- Department of Pathology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
9
|
Abstract
STUDY DESIGN A case report. OBJECTIVE We report a case of epidural lymphangioma in the cervical spine, and it manifested as a hemorrhagic cyst. SUMMARY OF BACKGROUND DATA Intraspinal lymphangioma is an uncommon tumor with only a few cases reported in the literature. Epidural lymphangioma presenting as a hemorrhagic cyst is extremely rare. METHODS The patient chosen was a 43-year-old woman with the chief complaint of neck pain and right upper extremity numbness of 2-month duration. RESULTS Cervical spine magnetic resonance (MR) imaging revealed an epidural cystic mass extending to the right C6-C7 neural foramen. The mass showed fluid-fluid levels on T2-weighted image and high-signal intensity on diffusion-weighted image. Surgical resection and histologic analysis confirmed the diagnosis of epidural lymphangioma with internal hemorrhage. CONCLUSION Epidural lymphangioma is a rare benign tumor. However, it should be included in the differential diagnosis of hemorrhagic cystic mass in the epidural space, which presented with fluid-fluid levels on MR imaging and high-signal intensity on diffusion weighted imaging.
Collapse
|
10
|
Ha BY, Park JB, Kim YM, Lyo IU. Lymphangioma in the epidural space of the thoracic spine. J Korean Neurosurg Soc 2010; 47:403-5. [PMID: 20539805 DOI: 10.3340/jkns.2010.47.5.403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 11/25/2009] [Accepted: 05/03/2010] [Indexed: 12/19/2022] Open
Abstract
A rare case of solitary intraspinal epidural lymphangioma is described with a review of the literature. A 16-year-old boy was admitted to our hospital with a history of two-year of progressive paraparesis. Magnetic resonance imaging study revealed a 2 x 2 x 6 cm sized epidural cystic mass in the thoracic spine. Surgical total removal and biopsy were performed. The final pathologic report on the mass indicated lymphangioma.
Collapse
Affiliation(s)
- Bok Yong Ha
- Department of Neurological Surgery, Ulsan University Hospital College of Medicine, University of Ulsan, Ulsan, Korea
| | | | | | | |
Collapse
|
11
|
Itakura E, Yamamoto H, Oda Y, Furue M, Tsuneyoshi M. VEGF-C and VEGFR-3 in a series of lymphangiomas: is superficial lymphangioma a true lymphangioma? Virchows Arch 2009; 454:317-25. [PMID: 19151999 DOI: 10.1007/s00428-008-0720-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 11/24/2008] [Accepted: 12/10/2008] [Indexed: 11/24/2022]
Abstract
Lymphangiomas are commonly regarded as vascular malformations during embryonic development rather than as true neoplasms. VEGF-C and VEGFR-3 are known to be active in the formation of lymphangiomas. However, the significance of the disorders seems to be obscured by confusing different entities. In 114 lymphangiomas, we investigated the clinicopathological features and the expression of VEGF-C and VEGFR-3. The age of patients with lymphangioma circumscriptum or intraabdominal lymphangioma was significantly higher than in patients with cavernous lymphangioma and in patients with cystic hygroma. In cavernous lymphangioma, the age of female patients was significantly higher than in male patients. Five adult cystic hygromas were identified. VEGF-C was detected in 21 of 58 (36%) cavernous lymphangiomas, ten of 28 (36%) cystic hygromas, 0 of 12 (0%) lymphangioma circumscriptum, and four of ten (40%) intraabdominal lymphangiomas. VEGFR-3 was detected in 43 of 58 (72%) cavernous lymphangiomas, 20 of 28 (71%) cystic hygromas, six of 12 (50%) lymphangiomas circumscriptum, and seven of ten (70%) intraabdominal lymphangiomas. VEGF-C was absent from superficial lymphangiomas associated with cavernous lymphangiomas. In typical cases of cavernous lymphangioma, VEGF-C was strongly expressed, suggesting that these cases possessed proliferative activity. In cystic hygroma and intraabdominal lymphangioma, VEGF-C was limited in its distribution. Superficial lymphangiomas more likely represent from peripheral lymphatic dilatation rather than due to growth factor.
Collapse
Affiliation(s)
- Eijun Itakura
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | | | | | | | | |
Collapse
|
12
|
McLoughlin GS, Nuchtern JG, Dauser RC, Sciubba DM, Gokaslan ZL, Wolinsky JP. Mediastinal lymphangioma presenting as an acute epidural hematoma. J Neurosurg Pediatr 2008; 1:474-6. [PMID: 18518699 DOI: 10.3171/ped/2008/1/6/474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Lymphangiomas are benign collections of blind-ended lymphatic and vascular channels. Lesions typically occur in the soft tissues of the head and neck, although any region of the body can be affected. Involvement of the spine is very rare. A complete resection is generally curative. On rare occasions, these tumors are complicated by infection or hemorrhage. The authors present an unusual case of a hemorrhagic lymphangioma in a 1-year-old male child. The lesion originated in the mediastinum and extended into the cervicothoracic epidural space via a neural foramen. This resulted in an acute epidural hematoma and quadriparesis. Emergency decompression resulted in full neurological recovery. This may be the first report of a lymphangioma resulting in an acute epidural hematoma and quadriparesis.
Collapse
Affiliation(s)
- Gregory S McLoughlin
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland 21287, USA
| | | | | | | | | | | |
Collapse
|
13
|
Chu M, Li G, Wei L, Lin Y, Qi J, Wang C, Zhao S. A rare case of cavernous lymphangioma in the epidural space of the cervicothoracic spine. Spine (Phila Pa 1976) 2007; 32:E48-51. [PMID: 17202881 DOI: 10.1097/01.brs.0000250992.55556.fe] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case report. OBJECTIVES To report and discuss a case of lymphangioma in the epidural space of the cervicothoracic spine. SUMMARY OF BACKGROUND DATA Lymphangioma of the soft tissue is not uncommon, but lymphangiomas presenting as a spinal soft tissue tumor in the epidural space are extremely rare. METHODS A 61-year-old woman with pain and numbness in the left arm. Magnetic resonance imaging demonstrated a half ring-shaped soft tissue mass in the left epidural space from the C6 to T1 level. The patient underwent osteoplastic laminectomy from C6 to T1. Histopathologic diagnosis of the resected tumor was cavernous lymphangioma. RESULTS One year after the operation, the patient reported mild pain in left upper limb, but there was no evidence of local recurrence on magnetic resonance imaging. CONCLUSION To the authors' knowledge, this is an extremely rare reported case of lymphangioma presenting as a spinal soft tissue tumor in the cervicothoracic epidural space. Further observation is recommended because of the possibility of local recurrence.
Collapse
Affiliation(s)
- Ming Chu
- Department of Neurosurgery, the First Affiliated Hospital, Harbin Medical University, Harbin, China.
| | | | | | | | | | | | | |
Collapse
|
14
|
Jiang YG, Xiang J, Zhang L. Intraspinal lymphangioma: 2 case reports and literature review. ACTA ACUST UNITED AC 2006; 66:430-6; discussion 436. [PMID: 17015133 DOI: 10.1016/j.surneu.2005.12.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 12/08/2005] [Indexed: 01/30/2023]
Abstract
BACKGROUND Lymphangioma of the soft tissue is not uncommon. However, as far as the authors know, intraspinal lymphangioma is clinically rare and very few cases have been reported previously. METHODS Two patients who had backache and acratia of the lower limbs and difficulty in relieving themselves were examined by plain radiography and magnetic resonance imaging before surgery. Treatment consisted of the usual technique of surgical resection of the tumor microscopically. Histological examination of the resected material confirmed the diagnosis. Postoperative follow-up assessment was performed by magnetic resonance imaging. RESULTS Intraspinal lymphangioma is very rare clinically and its cause remains controversial. Magnetic resonance imaging can obtain precise position fixing, but it is hard to make preoperative qualitative determination. The most effective treatment of intraspinal lymphangioma is to excise it totally. CONCLUSIONS The clinical appearance of intraspinal lymphangioma has no character. Magnetic resonance imaging is important in diagnosing it. The most effective treatment of intraspinal lymphangioma is to excise it totally. Further observation is recommended because of the possibility of local recurrence.
Collapse
|
15
|
Nagi S, Megdiche H, Bouzaïdi K, Haouet S, Khouja N, Douira W, Sebaï R, Chaabene S, Zitouna M, Touibi S. Imaging features of spinal epidural cavernous malformations. J Neuroradiol 2004; 31:208-13. [PMID: 15356446 DOI: 10.1016/s0150-9861(04)96993-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cavernous angioma or cavernoma is a vascular malformation that may affect any area in the neuraxis. Epidural location is very rare and therefore seldom considered in the differential diagnosis of spinal cord compression. We report two cases of epidural cavernous angiomas. The first case is a solitary and purely epidural dorsal cavernous angioma without foraminal expansion or bone modification causing spinal cord compression in a 35 year old woman. The second case is a solitary epidural dorsal cavernous angioma with foraminal extension causing spinal cord compression in a 56 year old woman. Histological confirmation is available for both cases. We describe the MRI features of this lesion insisting on its differential diagnosis on imaging.
Collapse
Affiliation(s)
- S Nagi
- Service de Neuroradiologie, Institut National de Neurologie, 1007 La Rabta, Tunis, Tunisie.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Nishio I, Mandell GL, Ramanathan S, Sumkin JH. Epidural labor analgesia for a patient with disseminated lymphangiomatosis. Anesth Analg 2003; 96:1805-1808. [PMID: 12761016 DOI: 10.1213/01.ane.0000066014.08416.df] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPLICATIONS We describe a case of a parturient with disseminated lymphangiomatosis involving the thorax, retroperitoneum, and lumbar vertebrae who received epidural labor analgesia. Clinical presentations vary depending on the organ systems involved, the extent of the disease, and the stage of pregnancy. Anesthetic implications are discussed.
Collapse
Affiliation(s)
- Isuta Nishio
- *Department of Anesthesiology, University of Pittsburgh, UPMC St. Margaret Pain Medicine Center, Pittsburgh, Pennsylvania; and Departments of †Anesthesiology and ‡Radiology, University of Pittsburgh, Magee-Womens Hospital, Pittsburgh, Pennsylvania
| | | | | | | |
Collapse
|