Surgical management of a cervical intramedullary hemangioblastoma presenting with intracystic hemorrhage by hemi-semi-laminectomy via a posterior approach. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Li, Jia; Jiang, Xiao-Hang; Chen, Ai-Qin; Ying, Guang-Yu; Shen, Fang; Zhu, Yong-Jian
• Is Part Of: Journal of international medical research. Volume 47:Issue 7(2019)
• Page Start: 3458
• Page End: 3464
• Publication Date: 2019-07
• Subjects: Cervical intramedullary hemangioblastoma -- intracystic hemorrhage -- minimally invasive surgery -- magnetic resonance imaging -- hemi-semi-laminectomy -- posterior transcystic approach; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060519847412
• Languages: English
• ISSNs: 0300-0605

Abstract

Background and Importance: Cervical spinal cord hemangioblastoma with intracystic hemorrhage is a rare entity and presents a challenge for clinicians with regard to its timely diagnosis and appropriate treatment. Case Presentation: A 35-year-old man presented with sudden-onset acute and progressive neck pain and severe radicular pain in his left upper limb. Motor weakness and numbness in the left upper and lower limbs with gait ataxia followed 2 days later. His initial diagnosis was acute myelitis, and he was treated with glucocorticoids for 2 weeks. Follow-up contrast-enhanced magnetic resonance imaging (MRI) suggested a spinal cystic hemangioblastoma with intracystic hemorrhage at the C3-4 level. The tumor was totally removed by minimally invasive unilateral hemi-semi-laminectomy via a posterior transcystic approach. The postoperative course was uneventful, and postoperative MRI revealed no residual tumor. The patient showed full neurological recovery at the 1.5-year follow-up, and computed tomography with a volume-rendering technique showed regrowth of the left C3 lamina. Conclusion: Close MRI follow-up and thin-section imaging are invaluable for the timely diagnosis of spinal hemangioblastoma with intracystic hemorrhage, which was safely removed via minimally invasive microsurgery in the present case.