Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor) Within Cauda Equina.

Tanaka, Masahiro; Hiyama, Akihiko; Sakai, Daisuke; Katoh, Hiroyuki; Sato, Masato; Watanabe, Masahiko · J Am Acad Orthop Surg Glob Res Rev · 2018

case_report · Level V

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Abstract

To describe a rare case of intravascular papillary endothelial hyperplasia (IPEH), also called as Masson's tumor, in a patient with the cauda equina syndrome presenting with low back pain and leg pain. There are no studies that have reported a case of IPEH within the cauda equina. A 40-year-old man with no prior medical history presented with low back pain and leg pain beginning approximately 5 years ago and a month ago, respectively. MRI revealed a mass at the L2-L3 level that was isointense on T1-weighted images and hypointense with partial areas of high signal intensity on T2-weighted images. A myelogram demonstrated an intradural lesion without any respiratory fluctuation of tumor position, thereby suggesting a metastatic lesion; however, no abnormalities were found on a full-body CT scan or serum investigations for tumor markers. Therefore, surgery was performed on the lesion, within the cauda equina, for diagnosis as well as treatment. Histopathological examination of the excised tumor indicated IPEH. The symptoms and quality of life improved postoperatively; there was no recurrence of the lesion. This is the first report of an IPEH intradural lesion within the cauda equina. Case report.