Cervicothoracic cutaneomeningospinal angiomatosis in adults (Cobb's syndrome): A case report of acute quadriparesis

Bilateral optic disc pits in a pediatric patient with Cobb syndrome

Purpose

To describe a patient with Cobb Syndrome, a rare congenital disorder characterized by cutaneous and spinal arteriovenous malformations, who was found to have bilateral optic nerve pits.

Observations

A 15-year-old boy diagnosed with Cobb Syndrome, manifesting as a large cutaneous port-wine stain associated with an underlying left paraspinous arteriovenous malformation resulting in severe scoliosis, presented for a screening ophthalmological exam. The patient had no visual symptoms. On examination, his visual acuity was 20/20 in each eye; however, bilateral optic disc pits were discovered on biomicroscopy and confirmed by spectral-domain optical coherence tomography.

Conclusion and importance

The unusual finding of bilateral optic disc pits in this rare congenital neurocutaneous disorder represents the first report of ophthalmic abnormalities in association with Cobb syndrome. Patients with Cobb Syndrome may be considered for screening ophthalmological exam for the detection of subclinical optic nerve abnormalities.

Cobb Syndrome Manifesting as Repetitive Seizures in a 10-Year-Old Girl: A Case Report and Literature Review

Cutaneous vertebral medullary angiomatosis, also known as Cobb syndrome, is a rare segmental neurocutaneous syndrome. This syndrome is considered to be a non-hereditary congenital disease that is usually associated with arteriovenous malformations in the skin and spine. The clinical manifestations are complex because the lesions can involve the spine, spinal cord, skin, and even the viscera. Here, we present the case of a 10-year-old girl who was admitted to hospital due to headache with two episodes of convulsions. Previous examination at another hospital found no evidence of any abnormalities on either cranial or intracranial vascular magnetic resonance imaging (MRI). However, the patient had a history of subcutaneous hemangioma. Following exhaustive tests at our hospital, she was diagnosed with Cobb syndrome. She received surgery, treatment for decreasing intracranial pressure, and hormonal and nutritional support. She subsequently remained stable, with no recurrence of convulsions over a 9-year follow-up period. Here, we expand upon the clinical manifestations of Cobb syndrome and propose mechanisms for the underlying pathogenesis. We hope that our experience can help avoid missed diagnoses and misdiagnosis and provide more clinical evidence for early diagnosis.

Chest wall resection for a giant angiomatosis lesion: A case report

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Angiomatosis lesions are very vascular.

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Surgical resection is optimal treatment.

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Preoperative treatment should be considered if reduction in tumor size will reduce surgical extent significantly.

Introduction

Angiomatosis is a rare and benign vascular lesion which can be located in various sites throughout the body, most commonly diagnosed in females in the first two decades of life.

Presentation of case

A 54-year-old female with no previous medical history presented with significant pain and discomfort associated with a 12.3 × 11.3 × 4.4 cm posterior chest wall mass invading the 4th and 5th ribs and extending into the thoracic cavity.

Discussion

Angiomatosis is a benign vascular lesion that can affect any soft tissue in the body. Typically, it has a female predilection and tends to involve the lower extremities. It is histologically characterized by a proliferation of blood vessels of varying sizes and has a high recurrence rate after excision. Significant blood loss can occur during resection.

Conclusion

Management of these lesions is challenging based on the infiltrative and vascular nature of the disease. Neoadjuvant therapy can be considered in select cases. Close surveillance is recommended due to high rates of recurrence.