Isolated flat capillary midline lumbosacral hemangiomas as indicators of occult spinal dysraphism.
OBJECTIVE
Historically, cutaneous stigmata representative of occult spinal dysraphism (OSD) have included lumbar hemangiomas. Frequently, this skin change is found in conjunction with other cutaneous alterations such as dermal sinus tracts and subcutaneous lipomas. Debate has recently surrounded the question of whether these skin changes in isolation might indicate underlying spinal disease. The authors reviewed their experience in their most recent 120 cases in which OSD was diagnosed.


METHODS
The authors retrospectively reviewed records obtained in 120 patients with OSD. They found that many of the patients reviewed harbored only a flat capillary hemangioma as an indicator of OSD. In 21 patients (17.5%) with only midline lumbosacral flat capillary hemangiomas, underlying OSD was present. No single variety of OSD had a higher incidence of association with this single cutaneous stigma.


CONCLUSIONS
Based on their experience, the authors recommend magnetic resonance (MR) imaging evaluation in cases involving this skin lesion in isolation to discern the potential for surgically significant spinal cord anomalies. Prospective studies are now needed to examine MR images obtained in all children with this lesion in the midline lumbosacral spine and assess for OSD.
Tubbs
R Shane
RS
Department of Cell Biology, University of Alabama at Birmingham, USA. richard.tubbs@ccc.uab.edu
Wellons
John C
JC
Iskandar
Bermans J
BJ
Oakes
W Jerry
WJ
D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D018324:Hemangioma, Capillary / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D009460:Neurologic Examination; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D016136:Spina Bifida Occulta / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery