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

Authors

Liam P Hughes, Thomas Jefferson UniversityFollow
Garrett Largoza, Thomas Jefferson UniversityFollow
Thiago S Montenegro, Thomas Jefferson UniversityFollow
Caio M Matias, Thomas Jefferson UniversityFollow
Anthony Stefanelli, Thomas Jefferson UniversityFollow
Mark T Curtis, Thomas Jefferson UniversityFollow
James S Harrop, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

3-19-2021

Comments

This is the author's manuscript version of the article from the jouranl Spinal Cord Series and Cases (2021) 7:21

The final version of the article can be found at the journal's webpage: https://doi.org/10.1038/s41394-021-00383-9

Abstract

INTRODUCTION: Intradural extramedullary capillary hemangiomas of the cauda equina are exceedingly rare, with only 20 previous cases reported. In the adult population, these tumors are rare and can arise in the central and peripheral nervous systems from the dura or spinal nerve roots. Intradural capillary hemangiomas of the cauda equina can yield symptoms such as lower extremity weakness, pain, and bladder and bowel dysfunction. The clinical symptomology and surgical management of this rare spinal lesion are reviewed in this case report.

CASE PRESENTATION: A 50-year-old male presented with progressive bilateral lower extremity weakness for 2 years, with recent bladder and bowel dysfunction. On physical exam, strength was symmetrically impaired in both lower extremities. Pre-operative magnetic resonance imaging (MRI) of the lumbar spine demonstrated a gadolinium-enhanced intradural lesion at the L4 level. Laminectomy was performed and the lesion was resected. Histopathological analysis determined that the tumor demonstrated features consistent with a capillary hemangioma.

DISCUSSION: Clinically, patients with capillary hemangiomas of the cauda equina present with space-occupying compressive deficits, including progressive low back and lower extremity pain, motor deficits, paresthesias, sensory loss, and bowel and bladder dysfunction. Acute presentation can transpire following a hemorrhagic episode, although this is more associated with cavernous rather than capillary hemangiomas. Our patient demonstrated non-acute, progressive weakness, and late-onset bladder and bowel dysfunction. This report demonstrates that this rare lesion should be included in the differential diagnosis of cauda equina lesions.

Recommended Citation

Hughes, Liam P; Largoza, Garrett; Montenegro, Thiago S; Matias, Caio M; Stefanelli, Anthony; Curtis, Mark T; and Harrop, James S, "Intradural extramedullary capillary hemangioma of the cauda equina: case report of a rare spinal tumor." (2021). Department of Neurosurgery Faculty Papers. Paper 184.
https://jdc.jefferson.edu/neurosurgeryfp/184

PubMed ID

33741893

Language

English