Sporadic hemangioblastoma of cauda equina: An atypical case report

Abstract

Background: Hemangioblastomas account for about 1%–3% of all central nervous system tumors. They are usually associated with the Von Hippel–Lindau syndrome and typically occur in the posterior fossa, or throughout the spinal neuraxis. Here, we report the unusual case of a sporadic cauda equina hemangioblastoma. Case Description: A 28-year-old Caucasian female patient presented with progressive low back pain of 2 months duration. The magnetic resonance (MR) revealed a heterogeneous intradural and extramedullary lesion at the L2 level; with intravenous contrast, there were vascular flow voids and surrounding vasogenic edema (i.e., measuring 4.1 cm × 3.5 cm). The patient underwent an L2 right hemilaminectomy under intraoperative neurophysiological monitoring. She was discharged the 4th postoperative day, neurologically intact. Literature describes 21 previous reports of sporadic isolated spinal hemangioblastomas. Conclusion: Although rare, sporadic, and isolated hemangioblastomas of the cauda equina should be included among the differential diagnoses of intradural spinal lesions, particularly when enhanced MR studies document serpentine flow voids.