Wu Liang, Yang Tao, Deng Xiaofeng, Yang Chenlong, Xu Yulun
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantan Xili, Dongcheng District, 100050, Beijing, China.
Childs Nerv Syst. 2014 Sep;30(9):1601-5. doi: 10.1007/s00381-014-2397-4. Epub 2014 Mar 18.
As a vascular malformation, venous angioma in the spinal cord is extremely rare. To our knowledge, there are only five case reports in the literature, and it has not been previously reported in the pediatric age group.
In this paper, we report on a 3-year-old patient who presented with progressive weakness in his left upper limb. Spinal magnetic resonance imaging (MRI) revealed an epidural cystic mass at the C6-T2 level. The lesion was diagnosed as venous angioma after total removal with laminectomy. Postoperatively, the patient remained symptom free, and no tumor recurrence was confirmed based on MRI at the time of the 18-month follow-up. The clinical, radiological, surgical, and pathological features of this abnormality are discussed, and all six reported cases were reviewed.
Venous angiomas should be included in the differential diagnosis of spinal cystic lesions in children. A definitive diagnosis is difficult based on MRI alone. This rare lesion is amenable to surgery, and gross total removal (GTR) is usually achievable due to a well-demarcated dissection plane. A good clinical outcome after GTR can be expected.
作为一种血管畸形,脊髓静脉血管瘤极为罕见。据我们所知,文献中仅有五例病例报告,且此前未见小儿年龄组的相关报道。
本文报告一例3岁患者,该患者出现左上肢进行性无力。脊髓磁共振成像(MRI)显示C6 - T2水平有硬膜外囊性肿块。经椎板切除术完全切除后,病变被诊断为静脉血管瘤。术后,患者无症状,在18个月随访时,基于MRI未证实有肿瘤复发。讨论了该异常的临床、影像学、手术及病理特征,并对所有六例报告病例进行了回顾。
静脉血管瘤应纳入小儿脊髓囊性病变的鉴别诊断。仅依靠MRI很难做出明确诊断。这种罕见病变适合手术治疗,由于解剖平面界限清晰,通常可实现全切除(GTR)。GTR术后有望获得良好的临床结果。