engleski

HEMANGIOBLASTOMA OF THE CAUDA EQUINA IN A 13-YEAR-OLD BOY ; A CASE REPORT

A rare case of hemangioblastoma of cauda equina in a 13-year-old boy is presented. Spinal hemangioblastomas are rare tumours, accounting for only 1.6 to 2.1% of all primary spinal neoplasms. In one third of the cases, spinal hemangioblastomas are part of the Hippel-Lindau-disease, which is characterised by hemangioblastomas of the central nervous system, especially of the cerebellum, by vascular tumours of the retina and by visceral lesions of the kidneys and the pancreas. Hemangioblastomas at the level of the cauda equina are uncommon ; only about 40 cases are known. A boy presented with a six-month history of permanent low back pain and sciatic pain. Neurological examination showed weakness of the right leg, with hypalgesia in the right, proximal dermatome L5. Electromyography (EMG) showed a lesion of L5 and S1 roots, especially on the right side. Because a computed topography (CT) of the lumbosacral spine was negative, a magnetic resonance imaging (MRI) of the spine was performed. The MRI of the lumbar spine confirmed an intradural process at the level L2/L3. The patient underwent surgery using microsurgical techniques. Laminectomy L2 to L3 was performed and after opening the dura, the roots of the cauda equina were identified. The yellow-white tumour was evident at the right root L5. Because no continuity of the root with the tumour was observed, a tumour of 20x10 mm was removed in toto with a resection of the nerve root. Histopathologic and immunohistochemical analysis of the tumour showed it to be a hemangioblastoma. A few days after surgery the boy had urinary disturbances, but without earlier pain. Three months later, the boy had no neurologic deficit and a repeated MRI showed no tumour recurrence.

hemangioblastoma

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