Hemangioblastoma of the filum terminale.
A 52-year-old man presented with low backache, paraesthesiae and spasticity of both lower limbs. He had urinary retention and constipation. Investigations revealed a vascular intradural cauda equina-conus tumor. MRI scan demonstrated an enhancing mass at the second and third lumbar vertebral levels. There were multiple dilated and tortuous veins draining from both poles of the tumor. Digital subtraction spinal angiogram showed the tumor to be supplied mainly by the radiculo-medullary artery from first lumbar artery and dural branches of the second and third lumbar arteries. At surgery, after pre-operative embolization, a well-defined tumor with an orange hue and fleshy consistency was encountered arising from the filum terminale. The tumor was excised en bloc. A sporadic hemangioblastoma arising from the filum terminale should be considered as a rare cause of back pain and sciatica. Total excision of the tumor offers cure.
Nadkarni
Trimurti D
TD
Department of Neurosurgery, King Edward Memorial Hospital, Seth GS Medical College, Parel, Mumbai 400 012, India. tdnadkarni@hotmail.com
Menon
Ram Kumar
RK
Desai
Ketan I
KI
Goel
Atul
A
D000792:Angiography; D002420:Cauda Equina / Q000473:pathology* / Q000601:surgery*; D018325:Hemangioblastoma / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology; D019635:Neurosurgical Procedures; D010292:Paresthesia / Q000209:etiology; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology* / Q000601:surgery*; D012585:Sciatica / Q000209:etiology; D013116:Spinal Cord / Q000473:pathology; D016055:Urinary Retention / Q000209:etiology