Liu Jonathan J, Lee Darrin J, Jin Lee-Way, Kim Kee D
Department of Neurological Surgery, University of California-Davis, 4860 Y. Street, Suite 3740, USA.
Department of Pathology, University of California-Davis, 2805 50 Street, Sacramento, CA. 95817, USA.
Surg Neurol Int. 2015 Apr 22;6(Suppl 3):S127-31. doi: 10.4103/2152-7806.155701. eCollection 2015.
Capillary hemangiomas are benign vascular tumors that rarely occur in the neuraxis. When encountered in the spine, prompt diagnosis and complete resection is crucial. On rare instances, these lesions can acutely hemorrhage, leading to sudden neurological decline. To date, there are only 16 reported cases of intradural capillary hemangiomas in the cauda equina.
We report a case of an intradural extramedullary cauda equina capillary hemangioma that resulted in back pain and lower extremity motor deficit. Initial magnetic resonance (MR) imaging demonstrated a bilobular intradural L3-4 cauda equina lesion. The lesion was isointense on T1-weighted imaging, mildly hyperintense on T2-weighted images and avidly enhancing after gadolinium administration. Pathology confirmed the diagnosis of capillary hemangioma.
Early diagnosis and treatment of this patient resulted in complete resection of the tumor and return of lower extremity motor function. Capillary hemangiomas should be considered in the differential diagnosis of cauda equina lesions. En bloc resection of these lesions is the mainstay of treatment.
毛细血管瘤是一种良性血管肿瘤，很少发生于神经轴。当在脊柱中发现时，及时诊断和完整切除至关重要。在罕见情况下，这些病变可急性出血，导致突然的神经功能衰退。迄今为止，仅有16例马尾硬膜内毛细血管瘤的报道病例。
我们报告一例硬膜内髓外马尾毛细血管瘤病例，该病例导致背痛和下肢运动功能障碍。最初的磁共振（MR）成像显示L3 - 4硬膜内马尾有一个双叶病变。该病变在T1加权成像上呈等信号，在T2加权图像上轻度高信号，注射钆后明显强化。病理证实为毛细血管瘤。
该患者的早期诊断和治疗导致肿瘤完整切除及下肢运动功能恢复。在马尾病变的鉴别诊断中应考虑毛细血管瘤。整块切除这些病变是主要的治疗方法。
