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Deska-Gauthier D, Hachem LD, Wang JZ, Landry AP, Yefet L, Gui C, Ellengbogen Y, Badhiwala J, Zadeh G, Nassiri F. Clinical, molecular, and genetic features of spinal meningiomas. Neurooncol Adv 2024; 6:iii73-iii82. [PMID: 39430393 PMCID: PMC11485713 DOI: 10.1093/noajnl/vdae123] [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] [Indexed: 10/22/2024] Open
Abstract
Spinal meningiomas comprise 25%-46% of all primary spinal tumors. While the majority are benign and slow-growing, when left untreated, they can result in significant neurological decline. Emerging clinical, imaging, and molecular data have begun to reveal spinal meningiomas as distinct tumor subtypes compared to their intracranial counterparts. Moreover, recent studies indicate molecular and genetic subtype heterogeneity of spinal meningiomas both within and across the classically defined WHO grades. In the current review, we focus on recent advances highlighting the epidemiological, pathological, molecular/genetic, and clinical characteristics of spinal meningiomas. Furthermore, we explore patient and tumor-specific factors that predict prognosis and postoperative outcomes. We highlight areas that require further investigation, specifically efforts aimed at linking unique molecular, genetic, and imaging characteristics to distinct clinical presentations to better predict and manage patient outcomes.
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Affiliation(s)
| | - Laureen D Hachem
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Justin Z Wang
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Alex P Landry
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Leeor Yefet
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Chloe Gui
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Yosef Ellengbogen
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jetan Badhiwala
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Farshad Nassiri
- Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Nogueira J, Sobreiro Silva J, Oliveira L, Cambango M, Ribeiro P. Cauda Equina Cavernoma: A Case Report and Literature Review. Cureus 2024; 16:e66586. [PMID: 39252750 PMCID: PMC11382809 DOI: 10.7759/cureus.66586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2024] [Indexed: 09/11/2024] Open
Abstract
Cavernous hemangiomas (or cavernomas) are benign vasculature malformations that occasionally occur in the central nervous system (CNS). The vast majority is found supratentorial, but cavernomas also appear on the spine, usually intramedullary. Cavernomas in the cauda equina are extremely rare, with only a few cases reported in the literature. We report a case of a cavernoma of the cauda equina in a 69-year-old woman with low back pain and right sciatica for two years. Lumbar MRI showed an intradural mass lesion at the L1-L2 level. She underwent surgery with resection of the lesion, which confirmed the diagnosis of cavernous hemangioma. A good clinical outcome was achieved. In addition to the case report, we present a literature review on all reported cauda equina cavernomas, discussing their clinical presentations, imaging characteristics, histological findings, and surgical management.
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Safadi AL, Osborne B, Chitnis T, Graves JS, Newsome SD, Zamvil SS, Solomon IH, Shin RK. A 28-Year-Old Woman With Left-Sided Weakness and Atypical MRI Lesions: From the National Multiple Sclerosis Society Case Conference Proceedings. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:e200157. [PMID: 37673687 PMCID: PMC10482384 DOI: 10.1212/nxi.0000000000200157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/10/2023] [Indexed: 09/08/2023]
Abstract
A 28-year-old woman presented with subacute relapsing left-sided weakness. MRI demonstrated both enhancing C3-C6 and nonenhancing T2-T4 lesions. Initial provisional diagnosis was inflammatory/autoimmune. Her left-sided weakness progressed despite immunosuppressive therapies. We reassessed our original suspected diagnosis because of an atypical clinicoradiologic course, leading to biopsy and a definitive diagnosis.
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Affiliation(s)
- Amy L Safadi
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA.
| | - Benjamin Osborne
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Tanuja Chitnis
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Jennifer S Graves
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Scott D Newsome
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Scott S Zamvil
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Isaac H Solomon
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
| | - Robert K Shin
- From the Georgetown Multiple Sclerosis and Neuroimmunology Center (A.L.S., B.O., R.K.S.), Department of Neurology, MedStar Georgetown University Hospital, Washington, DC; Brigham Multiple Sclerosis Center (T.C.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; Department of Neurosciences (J.S.G.), University of California San Diego School of Medicine, La Jolla; Department of Neurology (S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology and Program in Immunology (S.S.Z.), University of California, San Francisco; and Department of Pathology (I.H.S.), Brigham and Women's Hospital, Boston, MA
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Kliea M, Alsultan M, Chatty E, Qatleesh S, Hamzeh G. Spontaneous hemorrhage of spinal epidural capillary hemangioma resulting in hyperacute neurologic deficit: A case report. Medicine (Baltimore) 2023; 102:e35606. [PMID: 37861494 PMCID: PMC10589514 DOI: 10.1097/md.0000000000035606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/21/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Spinal epidural capillary hemangioma is a very rare variety of tumors, usually with a predilection for the thoracic spine. CASE PRESENTATION A 16-year-old female complained of hyperacute neurologic deficit progressed within hour, which presented by acute paraplegia, and loss of all sensations from her lower limbs up to her breasts. Neurologic exam revealed paralysis of lower limbs (0/5 on both legs) with a flaccid tone, absence of reflexes, weakness of the trunk with sensory level T4, bilateral flexion of plantar reflexes, and loss of sphincters' controls. Emergent magnetic resonance imaging showed a dumbbell-shaped epidural mass in the posterior aspect of the spinal canal at the T1-T2 level, measuring approximately 1.1 × 4.5 × 1.5 cm in size. The lesion was isointense on T1-weighted, hyperintense on T2-weighted, and a little enhancement after gadolinium administration. The surgery was obtained nearly 16 hours after paralysis, which eradicated the lesion with good hemostasis. Histological examination showed a well-organized vascular tissue that haphazardly arranged and confirmed the diagnosis of capillary hemangioma. Neurological improvement was quickly observed within days after surgery and further complete recovery was achieved 2 months after discharge. CONCLUSION We report an extremely rare case of spinal epidural capillary hemangioma, where acute spontaneous hemorrhage in the lesion resulted in the hyperacute neurologic deficit within an hour. Since these are benign lesions, the immediate surgical intervention results in a very favorable prognosis and is considered the treatment of choice. Also, this case highlighted and rose the question of a better neurologic improvement in younger age patients with spinal cord injury.
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Affiliation(s)
- Marwa Kliea
- Department of Neurology, Al Assad and Al Mouwasat University Hospitals, Damascus University, Faculty of Medicine, Damascus, Syria
| | - Mohammad Alsultan
- Department of Nephrology, Al Assad and Al Mouwasat University Hospitals, Damascus University, Faculty of Medicine, Damascus, Syria
| | - Eyad Chatty
- Histopathology Department at Al Assad University Hospital, Damascus University, Faculty of Medicine, Damascus, Syria
| | - Safaa Qatleesh
- Histopathology Department at Al Assad University Hospital, Damascus University, Faculty of Medicine, Damascus, Syria
| | - Ghassan Hamzeh
- Neurology Department at Al Assad University Hospitals, Damascus University, Faculty of Medicine, Damascus, Syria
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Hachem LD, Nater A, Fehlings MG. Spinal Meningiomas. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1416:69-78. [PMID: 37432620 DOI: 10.1007/978-3-031-29750-2_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Spinal meningiomas are relatively rare, but account for a significant proportion of primary spinal tumors in adults. These meningiomas can be found anywhere along the spinal column and their diagnosis is often delayed due to their slow growth and the lack of significant neurological symptoms until they reach a critical size, at which point signs of spinal cord or nerve root compression generally manifest and progress. If left untreated, spinal meningiomas can cause severe neurological deficits including rendering patients paraplegic or tetraplegic. In this chapter we will review the clinical features of spinal meningiomas, their surgical management, and detail molecular features that differentiate them from intracranial meningiomas.
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Affiliation(s)
- Laureen D Hachem
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Anick Nater
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
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Patel P, Mehendiratta D, Bhambhu V, Dalvie S. Clinical outcome of intradural extramedullary spinal cord tumors: A single-center retrospective analytical study. Surg Neurol Int 2021; 12:145. [PMID: 33948315 PMCID: PMC8088529 DOI: 10.25259/sni_839_2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two-thirds of largely benign intraspinal neoplasms. They occasionally present with acute neurological deterioration warranting emergent surgical intervention. Methods: Here, we reviewed a series of 31 patients with intradural extramedullary spinal tumors who underwent surgery from 2012 to 2019. Patients averaged 50.8 years of age, and there were 16 males and 15 females. Patients were followed for a minimum of 1 year. Multiple clinical outcome variables were studied (e.g., Karnofsky Performance Score [KPS], visual analog scale (VAS), and Frankel grade). Results: The majority of IESCT tumors were found in the thoracic spine 18 (58.06%) followed by the lumbar 8 (25.80%), cervical 1 (3.22%), and combined junctional tumors 4 (12.90%) (cervicothoracic-02 and thoracolumbar-02). Histopathological diagnoses included schwannomas-16 (51.61%), meningiomas-11 (35.48%), lipomas-2 (6.45%), hemangiomas-1 (3.22), and ependymomas-01 (03.22%). The VAS score was reduced in all cases, while KPS and Frankel grades were significantly improved. Complications included cerebrospinal fluid leakage, new/residual paresthesias, and tumor recurrence (12.50%). Conclusion: Most intradural extramedullary tumors are benign and are readily diagnosed utilizing MRI scans. Notably, good functional outcomes follow surgical intervention.
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Affiliation(s)
- Pratik Patel
- Department of Orthopaedic, Spine Division, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Dhanish Mehendiratta
- Department of Orthopaedic, Spine Division, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Vivek Bhambhu
- Department of Orthopaedic, Spine Division, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Samir Dalvie
- Department of Orthopaedic, Spine Division, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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Hwang L, Okoye CC, Patel RB, Sahgal A, Foote M, Redmond KJ, Hofstetter C, Saigal R, Mossa-Basha M, Yuh W, Mayr NA, Chao ST, Chang EL, Lo SS. Stereotactic body radiotherapy for benign spinal tumors: Meningiomas, schwannomas, and neurofibromas. JOURNAL OF RADIOSURGERY AND SBRT 2019; 6:167-177. [PMID: 31998537 PMCID: PMC6774487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 05/21/2019] [Indexed: 06/10/2023]
Abstract
Stereotactic body radiation therapy (SBRT) is a relatively new technology, and its use among patients with benign spinal tumors has limited prospective data. Similar to intracranial benign tumors treated successfully with SBRT, benign spinal tumors of the same histology can also develop, and SBRT may be an effective treatment alternative in inoperable or recurrent cases. Outcomes in patients with neurofibromatosis type 1, neurofibromatosis type 2, or schwannomatosis treated with SBRT have also been reported. Single institution reports have shown local control rates over 90% and improvement in clinical symptoms. The optimum dose and fractionation to maximize local control and minimize toxicity is unknown, with few incidences of radiation treatment-related toxicities. Given the location and benign nature of these tumors, careful management of dose to critical organs is essential. With continued follow-up, the optimum use of SBRT in patients with benign spinal tumors can be better defined.
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Affiliation(s)
- Lindsay Hwang
- Department of Radiation Oncology, University of Southern California, Los Angeles, CA, USA
| | - Christian C. Okoye
- Department of Radiation Oncology, St. Bernards Cancer Center, Jonesboro, AR, USA
| | - Ravi B. Patel
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON, Canada
| | - Matthew Foote
- Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON, Canada
| | - Kristin J. Redmond
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, 401 North Broadway, Suite 144, Baltimore, MD, USA
| | | | - Rajiv Saigal
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Harborview Medical Center, 325 9th Ave, Box 359728, Seattle, WA, USA
| | - William Yuh
- Department of Radiology, University of Washington, Harborview Medical Center, 325 9th Ave, Box 359728, Seattle, WA, USA
| | - Nina A. Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
| | - Samuel T. Chao
- Department of Radiation Oncology, Cleveland Clinic, Lerner College of Medicine, 9500 Euclid Ave, CA-50, Cleveland, OH, USA
| | - Eric L. Chang
- Department of Radiation Oncology, Norris Cancer Center and Keck School of Medicine at University of Southern California, 1441 Eastlake Ave, NOR G356, Los Angeles, CA, USA
| | - Simon S. Lo
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
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Chowdhary AS, Durai B, Mohanty J. MRI EVALUATION OF SPINAL CORD TUMOURS WITH HISTOPATHOLOGICAL CORRELATION. ACTA ACUST UNITED AC 2017. [DOI: 10.18410/jebmh/2017/1206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kim SK, Lee SH, Kim ES, Eoh W. Diffuse Large B-Cell Lymphoma Mimicking Schwannoma of Lumbar Spine. KOREAN JOURNAL OF SPINE 2016; 13:71-3. [PMID: 27437017 PMCID: PMC4949171 DOI: 10.14245/kjs.2016.13.2.71] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 11/19/2022]
Abstract
A rare case of solitary diffuse large B-cell lymphoma arising from the lumbar spinal nerve root is reported. A 37-year-old man presented with a 3-month history of progressive numbness and paraparesis in both legs. The initial diagnosis was benign primary intradural extramedullary tumor including schwannoma and meningioma. Histopathological examination revealed diffuse large B-cell lymphoma. While a well-defined T1 isointense mass is common in primary spinal schwannoma, the present case was atypical and had a yellowish neural component. The pathogenesis and radiological findings of spinal diffuse large B-cell lymphoma are discussed and related literature is reviewed.
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Affiliation(s)
- Seung-Kook Kim
- Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun-Ho Lee
- Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Sang Kim
- Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Whan Eoh
- Department of Neurosurgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Popescu M, Titus Grigorean V, Julieta Sinescu C, Dumitru Lupascu C, Popescu G, Mihaela Sandu A, Emil Plesea I. Cauda equina intradural extramedullary cavernous haemangioma: case report and review of the literature. Neurol Med Chir (Tokyo) 2013; 53:890-5. [PMID: 24097094 PMCID: PMC4508733 DOI: 10.2176/nmc.cr2012-0309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cavernous haemangioma (cavernoma) is a benign vascular lesion, exceptionally located in cauda equina. We report a case, diagnosed and operated in the Department of Neurosurgery from Pitesti County Emergency Hospital, of a 60-year-old woman with history of lumbar region distress, who presented with low back pain, paravertebral muscle contracture, and bilateral lumbar radiculopathy, with sudden onset after lifting effort. The preoperative diagnosis was done using computed tomography (CT) and magnetic resonance imaging (MRI), and the patient underwent surgery-two level laminectomy, dural incision, and tumor dissection from the cauda equina nerve roots under operatory microscope. Histopathological examination confirmed the positive diagnosis of cavernoma of cauda equina. The patient's outcome was favorable, without postoperative neurological deficits.
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Affiliation(s)
- Mihai Popescu
- Department of Neurosurgery, Emergency County Hospital
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Abstract
Capillary hemangiomas are benign tumors and tumor like conditions commonly involving skin and mucus membrane of head and neck region. They are extremely rare in the spinal cord. We report a 35-year-old male presenting with gradual progressive paraparesis over a period of 4 months. Magnetic resonance imaging showed a hypo- to isointense intradural mass at the level of D12 vertebral body on T1-weighted images and homogenous enhancement on gadolinium contrast. Complete surgical resection revealed intradural extramedullary tumor, which on histopathologic examination showed characteristics of capillary hemangioma. At 1.5 years followup patient was asymptomatic.
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Affiliation(s)
- Dhiraj Vithal Sonawane
- Department of Orthopaedics, Sir Jamshetjee Jejeebhoy Group of Hospital and Grant Medical College, Mumbai, India,Address for correspondence: Dr. Dhiraj Sonawane, Department of Orthopaedics, Sir Jamshetjee Jejeebhoy Group of Hospital and Grant Medical College, 2nd floor, Main Buliding, Mumbai - 400008, India. E-mail:
| | - Sanjay A Jagtap
- Department of Orthopaedics, Sir Jamshetjee Jejeebhoy Group of Hospital and Grant Medical College, Mumbai, India
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