case_images: PMC11006963_01
case_images: Time course and clinical findings of the patient.
case_images: fneur-15-1350780-g001.jpg
case_images: PMC11006963_01_fneur-15-1350780-g001.jpg
case_images: fig1
case_images: A 66-year-old Asian female presented with six-year history of lower back pain (Figure 1), which had exacerbated over the past three weeks, radiating to her right buttock and thigh.
case_images: Magnetic resonance imaging. Preoperative MR T2 and T1-weighted images demonstrate an intradural septate cystic mass with a similar intensity of cerebrospinal fluid located at the terminal end of the conus medullaris, with a small posterior nodular lesion (A,B). Preoperative MR T1-weighted contrast-enhanced images demonstrate homogenous enhancement of posterior nodule (arrow) and cystic wall (C-E). Postoperative MR T1-weighted contrast-enhanced image demonstrates the gross total resection of the mass (F).
case_images: fneur-15-1350780-g002.jpg
case_images: PMC11006963_01_fneur-15-1350780-g002.jpg
case_images: fig2
case_images: T12-L1 level (Figures 2A,B). The cyst was separated by a thin septum and presented a similar intensity of cerebrospinal fluid (CSF). After gadolinium administration, the nodule exhibited strong homogenous enhancement and the cystic wall was also homogeneously enhanced (Figures 2C-E). The patient's postoperative course was uneventful, with a repeated contrast-enhanced MRI conducted three days postoperatively confirmed the gross total resection of the tumor (Figure 2F).
case_images: Operative and pathological findings. During operation, a soft blister-like mass with cystic formation (arrows) was detected (A). We found that the lesion arose from the cauda equina (B). The mural nodule of the tumor was resected en bloc (C). Hematoxylin & eosin (magnification, x20) (D) showed lobular arrangement of numerous, tightly packed, capillary-sized vessels, indicating a capillary hemangioma.
case_images: fneur-15-1350780-g003.jpg
case_images: PMC11006963_01_fneur-15-1350780-g003.jpg
case_images: fig3
case_images: The dura was opened paramedially, exposing an intradural soft blister-like mass with cyst formation at the conus medullaris (Figures 3A,B). The tumor had an abundant blood supply and was tightly adhesive to the surrounding tissues. The cyst was drained, and the feeding vessels were coagulated and cut, followed by en-bloc resection of the tumor (Figure 3C). Pathological examination showed a lobular arrangement of numerous, tightly packed, capillary-sized vessels, confirming the diagnosis of a capillary hemangioma (Figure 3D).