Vaishya Sandeep, Chauhan Abhishek, Patir Rana, Gupta Rakesh K
Department of Neurosurgery, Fortis Memorial Research Institute Gurugram, Haryana, India.
Department of Neurosurgery, Fortis Memorial Research Institute Gurugram, Haryana, India.
World Neurosurg. 2019 May;125:451-455. doi: 10.1016/j.wneu.2019.01.067. Epub 2019 Jan 24.
Intramedullary capillary hemangiomas are rare lesions with only 14 cases reported so far and are found in middle-aged persons. Until now only a single case has been reported in the pediatric population. Ours was the second pediatric case and the youngest of all to be diagnosed with an intramedullary capillary hemangioma.
We are reporting the case of a 2-month male child who presented with features of hydrocephalus and spastic paraparesis. On magnetic resonance imaging he had features suggestive of a D10-11 intradural extramedullary lesion and hydrocephalus. We did a ventriculoperitoneal shunt followed by excision of the lesion in the same sitting. Intraoperatively it was found to be an intramedullary lesion, and histopathologic examination showed features suggestive of capillary hemangioma. Postoperatively he recovered well and there is no recurrence 18 months after surgery.
Intramedullary capillary hemangiomas are extremely rare lesions in infants but should be kept in mind while treating any patient with the spinal lesion. Further reporting of similar cases will help in understanding the natural history, pathogenesis, and management.
髓内毛细血管瘤是罕见病变,迄今为止仅报道过14例,多见于中年人。到目前为止,儿科患者中仅报道过1例。我们报道的是第二例儿科病例,也是所有被诊断为髓内毛细血管瘤的患者中最年幼的。
我们报告了1例2个月大男童,表现为脑积水和痉挛性截瘫。磁共振成像显示其具有提示胸10至胸11节段硬膜内髓外病变和脑积水的特征。我们先进行了脑室腹腔分流术,然后在同一次手术中切除病变。术中发现为髓内病变,组织病理学检查显示为毛细血管瘤特征。术后恢复良好,术后18个月无复发。
髓内毛细血管瘤在婴儿中极为罕见,但在治疗任何脊髓病变患者时都应予以考虑。进一步报告类似病例将有助于了解其自然史、发病机制和治疗方法。