Plexiform neurofibroma of the cauda equina - Case report

Plexiform neurofibroma of the cauda equina has been reported only twice pre viously. The authors report the first pediatric patient in whom such a tumo r has been found. A 4-year-old boy presented with low-back pain that radiat ed bilaterally into the L-4 and L-5 dermatomes. A dermal sinus noted at the midthoracic level was surrounded by a hemangiomatous lesion. Magnetic reso nance imaging confirmed the presence of the dermal sinus and revealed a wel l-defined lumbosacral mass that showed heterogeneous intensity with irregul ar enhancement. Intraoperatively, a solid mass, which engulfed the entire c auda equina, could not be dissected from the roots. The dermal sinus tract, however, was excised from the thoracic spine. The patient underwent radiot herapy to control the tumor and relieve his pain. Plexiform neurofibromas o f the cauda equina are characterized by an insidious and progressive clinic al course. The tumor mass may engulf all the roots of the cauda equina. No plexiform neurofibroma of the cauda equina has been reported to be associat ed with neurofibromatosis Type 1. The authors assume that the thoracic-leve l dermal sinus observed in this child was an incidental finding.