Purely extradural spinal nerve root hemangioblastomas

Aytar, Murat Hamit; Yener, Ulaş; Ekşi, Murat Şakir; Kaya, Behram; Özgen, Serdar; Sav, Aydın; Alanay, Ahmet

doi:10.4103/0974-8237.193255

Cited by 13 publications

(12 citation statements)

References 21 publications

(34 reference statements)

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“…Most of the reported cases involve the thoracic and lumbar regions, but spinal extradural location is extremely rare. 4 Cervical spine HBs are exceptional [5][6][7][8] and, to our knowledge, a pure extradural dumbbell HB in this location has not been described previously.…”

mentioning

confidence: 70%

“…Extradural involvement is relatively infrequent and usually derived from tumor growth and extension from its intradural component. 2 , 4 , 9 However, a pure extradural HB of the spinal nerve root is extremely rare, and association with VHL disease has been reported in up to 45% of the cases. 3 , 4 , 7 , 10 Aytar et al recently reviewed 21 studies that included 38 patients with pure extradural spinal HBs, 4 and most of the cases (85.4%) affected the thoracic or lumbar spine.…”

Section: Discussionmentioning

confidence: 99%

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A pure extradural hemangioblastoma mimicking a dumbbell nerve sheath tumor in cervical spine: illustrative case

Piquer-Belloch¹,

Rodríguez-Mena²,

Llácer-Ortega³

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Spinal extradural hemangioblastomas (HBs) are quite uncommon, with most reported cases involving the thoracic and lumbar areas. Therefore, the presence of a dumbbell-shaped pure extradural cervical HB is exceptional, making preoperative diagnosis particularly challenging. OBSERVATIONS The authors report a case of a 27-year-old woman who presented to their outpatient clinic with progressive cervicobrachialgia and numbness in the left arm. Magnetic resonance imaging showed a C5–6 intradural extramedullary lesion, and, despite some atypical features, the diagnosis of a possible neurogenic tumor was made. A multidetector computed tomography scan and angiography confirmed the expansion and remodeling of the left neural foramen as well as the highly vascularized nature of the mass. Preoperative embolization of the lesion was performed. Complete tumor resection was accomplished, followed by a C5–6 posterior fusion. Histopathology and immunohistochemistry revealed an HB. LESSONS HBs should be considered among the differential diagnosis of cervical extradural tumors. Exhaustive preoperative workup and surgical planning are decisive in order to attain gross-total resection with favorable outcomes.

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confidence: 70%

Section: Discussionmentioning

confidence: 99%

A pure extradural hemangioblastoma mimicking a dumbbell nerve sheath tumor in cervical spine: illustrative case

Piquer-Belloch¹,

Rodríguez-Mena²,

Llácer-Ortega³

et al. 2021

Journal of Neurosurgery: Case Lessons

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“…All included studies[ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 ] were coded and data were systematically extracted and compiled in a spreadsheet [ Table 2 ]. Data gathered from full-text articles included population demographics, study design, date of publication, location of the primary tumor, the primary treatment offered, recurrence rates, embolization use, re-surgery, and overall patient morbidity.…”

Section: Methodsmentioning

confidence: 99%

Spinal extradural hemangioblastoma: A systematic review of characteristics and outcomes

Arumalla

Deora

Rao

et al. 2020

J Craniovert Jun Spine

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Extradural spinal nerve root hemangioblastoma is a rare entity with very few cases reported in the literature. A comprehensive picture of the treatments and outcomes of the same is thus not available. A systematic search was done according to PRISMA guidelines. Search criteria included terms: spinal extradural hemangioblastoma, extradural hemangioblastoma, and spinal root hemangioblastoma. The parameters considered were treatment, motor, and sensory outcome, association with von-Hippel-Lindau (VHL) syndrome. Twenty-two studies (19 full text articles) were available for the review. A total of 39 cases of extradural spinal nerve root hemangioblastoma have been reported. These cases had a median age of 44 years with male predominance (2:1) and up to 48% occur in the thoracic level, similar to our case. Thirty-six percent of patients were associated with VHL syndrome. Surgical resection was the primary modality of treatment with embolization used in selected cases (20%). They had mean follow-up of 23 (±11) months. The prognosis was better than the intradural counterpart with no motor deficit and sensory deficit in only 9%. Preoperative identification of the extradural nature of this pathology and complete excision at the first surgery offers excellent outcomes compared to intradural lesion. Targeted embolization may be used in cases anticipated with high blood loss.

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“…[4] Patients with foraminal/root lesions should undergo preoperative angiography/arterial embolization followed by gross total surgical excision. [2] Here, a 58-year-old male with an extradural/foraminal dumbbell-shaped left thoracic T3-T4 hemangioblastoma with an intracanalicular component required the combined expertise of neurosurgery and thoracic surgery to achieve a gross total tumor excision.…”

Section: Introductionmentioning

confidence: 99%

Extradural thoracic nerve root hemangioblastoma approached by a combined posterior thoracic spine and video-assisted thoracoscopic surgery: A case report

Roque

Cabral

Rodrigues

et al. 2022

Surgical Neurology International

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Background: Hemangioblastomas commonly occur in the posterior fossa and are typically attributed to sporadic or familial Von Hippel–Lindau disease. Spinal hemangioblastomas, found in 7–10% of patients, are usually located within the cord (i.e., intramedullary). Here, a 58-year-old male presented with a purely extradural hemangioblastoma involving a spinal root that was surgically excised. Case Description: A 58-year-old male was admitted with a progressive paraparesis and incomplete sensory deficit. The magnetic resonance imaging documented a solid dumbbell-shaped lesion that extended through the left T3-T4 foramen resulting in nerve root and spinal cord compression. Following arterial embolization and lesion excision by both neurosurgeons and thoracic surgeons, the patient’s deficits improved. The postoperative computed tomography scan documented complete tumor removal, and the neuropathology revealed a hemangioblastoma. Conclusion: Here, we describe a 58-year-old male with a purely extradural thoracic foraminal T3-T4 dumbbell-shaped hemangioblastoma successfully treated by both embolization and surgical excision.

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Purely extradural spinal nerve root hemangioblastomas

Cited by 13 publications

References 21 publications

A pure extradural hemangioblastoma mimicking a dumbbell nerve sheath tumor in cervical spine: illustrative case

A pure extradural hemangioblastoma mimicking a dumbbell nerve sheath tumor in cervical spine: illustrative case

Spinal extradural hemangioblastoma: A systematic review of characteristics and outcomes

Extradural thoracic nerve root hemangioblastoma approached by a combined posterior thoracic spine and video-assisted thoracoscopic surgery: A case report

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