Tanaka Masahiro, Hiyama Akihiko, Sakai Daisuke, Katoh Hiroyuki, Sato Masato, Watanabe Masahiko
Department of Orthopaedic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
J Am Acad Orthop Surg Glob Res Rev. 2018 Nov 5;2(11):e087. doi: 10.5435/JAAOSGlobal-D-17-00087. eCollection 2018 Nov.
To describe a rare case of intravascular papillary endothelial hyperplasia (IPEH), also called as Masson's tumor, in a patient with the cauda equina syndrome presenting with low back pain and leg pain.
There are no studies that have reported a case of IPEH within the cauda equina.
A 40-year-old man with no prior medical history presented with low back pain and leg pain beginning approximately 5 years ago and a month ago, respectively. MRI revealed a mass at the L2-L3 level that was isointense on T1-weighted images and hypointense with partial areas of high signal intensity on T2-weighted images. A myelogram demonstrated an intradural lesion without any respiratory fluctuation of tumor position, thereby suggesting a metastatic lesion; however, no abnormalities were found on a full-body CT scan or serum investigations for tumor markers. Therefore, surgery was performed on the lesion, within the cauda equina, for diagnosis as well as treatment.
Histopathological examination of the excised tumor indicated IPEH. The symptoms and quality of life improved postoperatively; there was no recurrence of the lesion.
This is the first report of an IPEH intradural lesion within the cauda equina.
Case report.
描述一例罕见的血管内乳头状内皮增生(IPEH),也称为马松瘤,发生在一名表现为腰痛和腿痛的马尾综合征患者中。
尚无研究报道马尾内发生IPEH的病例。
一名40岁男性,既往无病史,分别于大约5年前和1个月前开始出现腰痛和腿痛。MRI显示L2-L3水平有一肿块,在T1加权像上呈等信号,在T2加权像上呈低信号,部分区域有高信号。脊髓造影显示硬膜内病变,肿瘤位置无任何呼吸波动,提示为转移瘤;然而,全身CT扫描或肿瘤标志物血清检查均未发现异常。因此,对马尾内的病变进行了手术,以明确诊断并进行治疗。
切除肿瘤的组织病理学检查显示为IPEH。术后症状和生活质量得到改善;病变无复发。
这是首例关于马尾硬膜内IPEH病变的报道。
病例报告。