Department of Neurologic Surgery, Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
World Neurosurg. 2024 May;185:e951-e962. doi: 10.1016/j.wneu.2024.03.003. Epub 2024 Mar 6.
Capillary hemangiomas are rare vascular lesions that rarely affect the central nervous system. When they present within the spinal canal, they are typically confined intradurally, with intramedullary extension rare. We present a rare case of spinal intramedullary capillary hemangioma, with a systematic review of the literature.
Medical records and imaging data were retrospectively reviewed using the health record software EPIC (Verona, Wisconsin, USA) and the radiology management software system RIS/PACS (Radiology Information System/Picture Archiving and Communication System; QREADS). The report was written in accordance with the CARE (case reports) guidelines. We also performed a systematic review of the literature on all cases of intramedullary spinal capillary hemangiomas in accordance with PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines.
We report a case of a 54-year-old man who presented with progressive paraplegia and sensory deficits in the lower extremities. Spinal magnetic resonance imaging showed an intramedullary enhancing lesion centered at T11 with associated spinal cord compression. He underwent thoracic laminectomy and gross total resection of the lesion without complications and subsequent improvement on his neurological examination. Histological examination showed findings consistent with a capillary hemangioma. The literature review also documented 21 studies with a combined total of 38 cases of intramedullary spinal capillary hemangioma.
Purely intramedullary capillary hemangiomas are unusual spinal lesions with only a few cases reported in the literature. These should be considered in the differential diagnosis of intramedullary tumors. Surgical management remains the first line of treatment for symptomatic patients.
毛细血管血管瘤是罕见的血管病变,很少影响中枢神经系统。当它们出现在椎管内时,通常局限于硬脊膜内,很少有向髓内延伸的情况。我们报告一例罕见的脊髓内毛细血管瘤病例,并对文献进行了系统回顾。
使用健康记录软件 EPIC(美国威斯康星州的 Verona)和放射学管理软件系统 RIS/PACS(放射信息系统/图像存档和通信系统;QREADS)回顾性地审查了病历和影像学数据。报告的编写符合 CARE(病例报告)指南。我们还按照 PRISMA(系统评价和荟萃分析的首选报告项目)指南对所有脊髓内毛细血管瘤病例进行了文献系统回顾。
我们报告了一例 54 岁男性,表现为进行性下肢截瘫和感觉障碍。脊髓磁共振成像显示 T11 为中心的脊髓内强化病变,伴有脊髓压迫。他接受了胸椎椎板切除术和病变的大体全切除,没有并发症,随后神经检查得到改善。组织学检查显示符合毛细血管瘤的发现。文献复习还记录了 21 项研究,共 38 例脊髓内毛细血管瘤。
纯粹的脊髓内毛细血管瘤是罕见的脊髓病变,文献中仅报道了少数病例。在鉴别诊断脊髓内肿瘤时应考虑这些病变。手术治疗仍然是有症状患者的一线治疗方法。