Intradural extramedullary capillary hemangioma of the cauda equina: case report of a rare spinal tumor

Hughes, Liam P; Largoza, Garrett; Montenegro, Thiago S.; Matias, Caio; Stefanelli, Anthony; Curtis, Mark

doi:10.1038/s41394-021-00383-9

Cited by 4 publications

(11 citation statements)

References 10 publications

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“…7 Postoperative serial imaging may be performed with the rationale that if mucocutaneous and intracranial capillary hemangiomas can recur, perhaps capillary hemangiomas in the spine may recur, too. 2,24,27,28 However, we have not found any documented cases of recurrent spinal capillary hemangiomas. 2,9 We will be following our patient clinically.…”

Section: Discussionmentioning

confidence: 72%

“…2,18 Diagnosis requires histopathological analysis and immunohistochemical stains for CD31, CD34, neuron-specific enolase, and S100. 7,18,24 Occasionally, capillary hemangiomas can demonstrate increased proliferative index, 2,23 which implies potential for growth, but the clinical significance of this finding is unclear. Others have reported little or no increase in proliferative markers.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Intradural capillary hemangiomas are believed to arise from capillaries of the nerve root, dura mater, or pia mater during dysregulated embryologic angioblastic differentiation. 19 Intradural extramedullary capillary hemangiomas of the cauda equina are usually diagnosed between ages 40 and 60 years, with a predilection toward the male sex 3,24 (Table ; note that Babu et al 3 also published a case series of 19 patients with spinal hemangiomas, 8 which were classified as capillary hemangiomas and included vertebral locations. Their article did not provide any of the details summarized in this table and was therefore not included.…”

Section: Discussionmentioning

confidence: 99%

“…10 Intradural, extramedullary capillary hemangiomas of the lumbar spine are even rarer, with only around 25 cases reported in the literature. 4,5,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Intradural capillary hemangiomas are believed to arise from capillaries of the nerve root, dura mater, or pia mater during dysregulated embryologic angioblastic differentiation. 19 Intradural extramedullary capillary hemangiomas of the cauda equina are usually diagnosed between ages 40 and 60 years, with a predilection toward the male sex 3,24 (Table ; note that Babu et al 3 also published a case series of 19 patients with spinal hemangiomas, 8 which were classified as capillary hemangiomas and included vertebral locations.…”

Section: Discussionmentioning

confidence: 99%

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Resection of an Intradural Extramedullary Capillary Hemangioma in the Lumbar Spine

Srienc

Mahlokozera

Connor

et al. 2022

Operative Neurosurgery

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BACKGROUND AND IMPORTANCE:Capillary hemangiomas are space-occupying lesions that rarely affect the central nervous system. When they present within the spinal canal, they can cause insidious symptoms and threaten neurological function. In this study, we present a case of an intradural extramedullary capillary hemangioma of the lumbar spine, discuss our management strategy, and review the current literature. For the first time for this diagnosis, we also provide an operative video.CLINICAL PRESENTATION:The patient is a previously healthy 40-year-old man who presented with complaints of progressive low back and leg pain, numbness, and intermittent subjective urinary incontinence. MRI revealed a discrete, homogenously enhancing intradural extramedullary lesion at L4. This lesion was resected by performing an L4 laminoplasty, which entails en bloc removal of the L4 lamina and then securing it back into place once the intradural resection and dural closure are completed. Histological analysis revealed a diagnosis of capillary hemangioma. The patient had full resolution of his symptoms postoperatively.DISCUSSION:Definitive management of spinal capillary hemangiomas involves gross total resection and can be accomplished with laminoplasty. Because these benign tumors can be adherent to adjacent structures, intraoperative neuromonitoring is helpful adjunct to preserve neurological function for a good outcome.CONCLUSION:Capillary hemangiomas rarely affect the spine but should be considered on the list of differential diagnoses of intradural lesions.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Resection of an Intradural Extramedullary Capillary Hemangioma in the Lumbar Spine

Srienc

Mahlokozera

Connor

et al. 2022

Operative Neurosurgery

View full text Add to dashboard Cite

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“…This involves a detailed review of symptoms and physical examination to assess factors such as stability, sensation, strength, reflexes, spinal alignment, and range of motion. Imaging studies, including MRI, computed tomography (CT), and myelography, play a critical role in the diagnosis [ 17 , 18 ]. Contrast-enhanced MRI is the preferred imaging method to fully characterize these masses and the relationship of the tumor to the spinal cord, dura, and nerve roots.…”

Section: Discussionmentioning

confidence: 99%

Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review

Lim

2023

International Journal of Surgery Case Reports

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A case report of lobular intradural extramedullary capillary hemangioma in a 14-year-old patient: resection and reconstruction

Johnson,

Espinosa,

Tavakoli

et al. 2024

J Spine Surg

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Background Intradural, extramedullary capillary hemangiomas of the cauda equina are exceedingly rare malformations arising from the endothelial cells of the nervous system vasculature. Roughly 20 cases have been reported in the literature, with the youngest and only pediatric case being in a 17-year-old patient. We report the youngest case of intradural extramedullary capillary hemangioma of the cauda equina in a 14-year-old patient. Case Description A 14-year-old female presented with two-month history of low back pain with bilateral leg pain and numbness. Magnetic resonance imaging (MRI) revealed an L2 well-defined homogenous contrast-enhancing intradural, extramedullary mass causing severe spinal canal stenosis. Patient underwent laminoplasty for resection of an intradural tumor. Intraoperative hemostasis was readily achieved via early identification and coagulation of the predominate feeding vessel. Postoperatively, the patient awoke with no deficits and resolved leg pain. A 3-month postoperative MRI revealed no tumor recurrence and fully healed lamina. Conclusions Given the benign nature, the operative goal is complete excision of the tumor without damage to surrounding neural structures. Postoperatively the goal is relief of pain and improvement in neurologic function. To our knowledge we report the first case in which laminoplasty is utilized for the treatment of this pathology in a pediatric patient. Evidence for laminoplasty in this patient population is sparse and future studies are still needed. In any case, reconstruction of the surgical site in a manner that returns the patient’s normal anatomy should be strongly considered especially in younger patients.

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Intradural extramedullary capillary hemangioma of the cauda equina: case report of a rare spinal tumor

Cited by 4 publications

References 10 publications

Resection of an Intradural Extramedullary Capillary Hemangioma in the Lumbar Spine

Resection of an Intradural Extramedullary Capillary Hemangioma in the Lumbar Spine

Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review

A case report of lobular intradural extramedullary capillary hemangioma in a 14-year-old patient: resection and reconstruction

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