Hemangioblastoma of the filum terminale: Case report

OBJECTIVE AND IMPORTANCE: Tumors of the cauda equina and specifically the f ilum terminale are uncommon. We report the fourth case of a hemangioblastom a occurring in the filum terminale. CLINICAL PRESENTATION: 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 n eurologically intact. He was found to have a large, enhancing mass filling the thecal sac at L2-L3. INTERVENTION: The tumor was found to be attached to the filum terminale and was cleanly dissected off en tote, Microscopically, the mass consisted of endothelial cells in addition to abundant fat-laden stromal cells and retic ulum. CONCLUSION: We present a case report and a review of the literature. Our pa tient was the first to exhibit no radicular complaints. The diagnosis was d elayed in all four cases and was not determined until the time of surgery. Complete excision offers the best chance for cure, and spinal angiography c an aid in diagnosis. However, a high index of suspicion is needed for preop erative detection.