Multiple hemangiomas (hemangiomatosis) of the cauda equina and spinal cord- Case report

A case of multiple hemangiomas of the cauda equina nerve roots, conus medul laris, and lower spinal cord is described. The 74-year-old male patient pre sented with a 9-month history of progressive bilateral leg weakness. He had a history of lymphoma at the age of 39 years and renal cell carcinoma in h is early 40s. Neither disease was evident at the time of this presentation. A magnetic resonance image revealed multiple enhancing nodules in the caud a equina region as well as on the pial surface of the lower thoracic spinal cord and conus medullaris. The patient underwent an L2-3 laminectomy. Caud a equina nerve roots were found to be studded with numerous purple nodules, the largest measuring 6 to 8 mm. The nodules were adherent to nerve roots from which they could not be resected. Two lesions were histologically exam ined and found to be capillary hemangiomas. Twelve months into an uneventfu l postoperative course, the patient is neurologically unchanged. This uniqu e case might represent a distinct form of hemangiomatosis confined to the c auda equina nerve roots and spinal cord.