Intravascular papillary endothelial hyperplasia causing cauda equina compression: Case report

OBJECTIVE AND IMPORTANCE: Intravascular papillary endothelial hyperplasia ( Masson's vegetant hemangioendothelioma) is a rare condition affecting the n euraxis. In the literature, only one case of this lesion involving the vert ebral canal with spinal cord compression has been reported. We present a ca se of cauda equina compression due to this abnormality. CLINICAL PRESENTATION: A 17-year-old boy was admitted at our hospital with pain, numbness, paresis of the left lower extremity, and bladder dysfunctio n of approximately 1 month's duration. Computed tomography and magnetic res onance imaging of the spine revealed a tumor within the spinal canal at the T12-L1 level. INTERVENTION: The patient underwent a T12-L1 laminectomy. An epidural red n odular tumor was visualized and totally resected. The findings of the patho logical examination were compatible with intravascular papillary endothelia l hyperplasia. At follow-up examination 1 month after the operation, the pa tient had complete resolution of the pain, and the motor deficit and bladde r dysfunction had improved significantly. CONCLUSION: This rare benign vascular lesion may be clinically and histopat hologically mistaken for an angiosarcoma. Because the intravascular papilla ry endothelial hyperplasia can be cured by complete surgical resection, it is important to distinguish between these two lesions to avoid inappropriat e aggressive treatment.