Hemangioblastoma of the filum terminale: case report.
OBJECTIVE
Tumors of the cauda equina and specifically the filum terminale are uncommon. We report the fourth case of a hemangioblastoma occurring in the filum terminale.


METHODS
This 35-year-old man presented with a 4-year history of low back pain that had been previously diagnosed as a bulging disc and exhibited severe pain in response to percussion of his lower back but was neurologically intact. He was found to have a large, enhancing mass filling the thecal sac at L2-L3.


METHODS
The tumor was found to be attached to the filum terminale and was cleanly dissected off en toto. Microscopically, the mass consisted of endothelial cells in addition to abundant fat-laden stromal cells and reticulum.


CONCLUSIONS
We present a case report and a review of the literature. Our patient was the first to exhibit no radicular complaints. The diagnosis was delayed in all four cases and was not determined until the time of surgery. Complete excision offers the best chance for cure, and spinal angiography can aid in diagnosis. However, a high index of suspicion is needed for preoperative detection.
Tibbs
R E
RE
Department of Neurosurgery, University of Mississippi Hospitals and Clinics, Jackson 39216, USA.
Harkey
H L
HL
Raila
F A
FA
D000328:Adult; D002420:Cauda Equina / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D018325:Hemangioblastoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology / Q000601:surgery*