Spinal intravascular papillary endothelial hyperplasia [Neurosurgery Wiki]

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====== Spinal intravascular papillary endothelial hyperplasia ======

{{ ::spinal_intravascular_papillary_endothelial_hyperplasia.jpg?300|}}

In the literature, only nine cases of [[intravascular papillary endothelial hyperplasia]] involving the [[vertebral canal]] with [[spinal cord compression]] has been reported
((Oktar N, M Ozer H, Demirtas E. Spinal intravascular papillary endothelial
hyperplasia. Case report and review of the literature. Br J Neurosurg. 2019 Apr
9:1-3. doi: 10.1080/02688697.2019.1597832. [Epub ahead of print] PubMed PMID:
30964346.
)).

This rare pathology should be in the [[differential diagnosis]] when spinal cord compressive [[myelopathy]] is encountered
((Behera BR, Panda RN, Mishra S, Dhir MK. Masson Hemangioma-An Unusual Cause of 
Thoracic Compressive Myelopathy. World Neurosurg. 2017 Feb;98:876.e9-876.e13.
doi: 10.1016/j.wneu.2016.11.099. Epub 2016 Nov 25. Review. PubMed PMID: 27894942.))

This rare benign vascular lesion may be clinically and histopathologically mistaken for an [[angiosarcoma]]. Because the intravascular papillary endothelial hyperplasia can be cured by complete surgical resection, it is important to distinguish between these two lesions to avoid inappropriate aggressive treatment.
((Taricco MA, Vieira JO Jr, Machado AG, Ito FY. Intravascular papillary
endothelial hyperplasia causing cauda equina compression: case report.
Neurosurgery. 1999 Dec;45(6):1478-80. PubMed PMID: 10598718.)).



===== Case reports =====

Oktar et al from [[Izmir]] presented a 37-year-old man with thoracic location mimicking [[schwannoma]]
((Oktar N, M Ozer H, Demirtas E. Spinal intravascular papillary endothelial
hyperplasia. Case report and review of the literature. Br J Neurosurg. 2019 Apr
9:1-3. doi: 10.1080/02688697.2019.1597832. [Epub ahead of print] PubMed PMID:
30964346.
)).

A 32-year-old man presented with paraplegia secondary to extradural compression at the T4-5 level
((Behera BR, Panda RN, Mishra S, Dhir MK. Masson Hemangioma-An Unusual Cause of 
Thoracic Compressive Myelopathy. World Neurosurg. 2017 Feb;98:876.e9-876.e13.
doi: 10.1016/j.wneu.2016.11.099. Epub 2016 Nov 25. Review. PubMed PMID: 27894942.))

----
A 17-year-old boy was admitted with pain, numbness, paresis of the left lower extremity, and bladder dysfunction of approximately 1 month's duration. Computed tomography and magnetic resonance imaging of the spine revealed a tumor within the spinal canal at the T12-L1 level.

The patient underwent a T12-L1 laminectomy. An epidural red nodular tumor was visualized and totally resected. The findings of the pathological examination were compatible with intravascular papillary endothelial hyperplasia. At follow-up examination 1 month after the operation, the patient had complete resolution of the pain, and the motor deficit and bladder dysfunction had improved significantly
((Taricco MA, Vieira JO Jr, Machado AG, Ito FY. Intravascular papillary
endothelial hyperplasia causing cauda equina compression: case report.
Neurosurgery. 1999 Dec;45(6):1478-80. PubMed PMID: 10598718.)).

===== References =====