Cavernoma of the cauda equina.
Surg Neurol Int. 2018;9:174
Authors: Apostolakis S, Mitropoulos A, Diamantopoulou Ok, Vlachos Ok
Background: Cavernomas are benign malformations of the vasculature. Within the central nervous system, they’re principally positioned supratentorially. Nonetheless, in adults, cavernomas additionally comprise about three% of all subdural spinal twine tumors. Notably, cavernomas of the cauda equina are extraordinarily uncommon, with solely 23 instances reported within the literature. Right here, we report the 24th case involving a 77-year-old male.
Case Description: A 77-year-old male introduced with low again ache for three years period. His historical past included prostate most cancers, pores and skin melanoma, and a sick sinus syndrome requiring a pacemaker. An enhanced computed tomography of the lumbar backbone confirmed an inhomogeneously enhanced, intramedullary mass, positioned on the L3 degree. The affected person underwent an L3 hemilaminectomy with gross complete excision of the lesion. Macroscopically, the tumor was mulberry-shaped and properly demarcated. Nonetheless, it was strongly adherent to a nerve root of the cauda equina which required resection. The histologic examination was in keeping with a cavernoma. The affected person subsequently absolutely recovered and not using a focal neurological deficit.
Conclusions: Cavernomas of the cauda equina are extramedullary, come up on the interior facet of the dura, and could also be tightly adhered to the nerve roots. To realize gross complete excision, the concerned nerve could need to be sacrificed; in some instances, this will end in a everlasting neurological deficit. Of curiosity, half of the cauda equina lesions have been beforehand present in sufferers who had prior radiotherapy; this was not the case on this affected person.
PMID: 30210907 [PubMed]