Cervical dumbbell intra-extradural hemangioblastoma: total removal through the lateral approach: technical case report.
OBJECTIVE
Extradural hemangioblastomas account for 8 to 12% of all spinal hemangioblastomas. Among them, intra-extradural forms with a dumbbell extension are extremely rare. We report a case of intra-extradural hemangioblastoma involving the C6 cervical nerve root.


METHODS
The patient was a 31-year-old woman presenting with signs of myelopathy and C6 radiculopathy on the right side. A computed tomographic scan and magnetic resonance imaging demonstrated a dumbbell tumor that had developed through the C5-C6 intervertebral foramen. Angiography revealed a well-circumscribed mass with feeders from the vertebral artery and the deep cervical artery.


METHODS
The tumor was totally removed through the lateral approach, with control of the vertebral artery and sacrifice of the C6 cervical nerve root. Limited bone drilling to enlarge the foramen permitted us to reach and resect the intradural component. Histopathological examination confirmed the diagnosis of hemangioblastoma. Follow-up was uneventful.


CONCLUSIONS
This is the sixth reported case of a cervical dumbbell hemangioblastoma investigated by computed tomographic scanning and MRI but the first one resected via the lateral approach. The lateral approach seems appropriate for surgical resection because it provides primary control of the vascular feeders and access to the extradural and intradural components.
Barrey
Cédric
C
Department of Neurosurgery, Hôpital Neurologique P. Wertheimer, Lyon, France. c.barrey@wanadoo.fr
Kalamarides
Michel
M
Polivka
Marc
M
George
Bernard
B
D000328:Adult; D002574:Cervical Vertebrae; D005260:Female; D018325:Hemangioblastoma / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D009408:Nerve Compression Syndromes / Q000209:etiology; D013117:Spinal Cord Compression / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed