Mediastinal lymphangioma presenting as an acute epidural hematoma

Case report

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✓ Lymphangiomas are benign collections of blind-ended lymphatic and vascular channels. Lesions typically occur in the soft tissues of the head and neck, although any region of the body can be affected. Involvement of the spine is very rare. A complete resection is generally curative. On rare occasions, these tumors are complicated by infection or hemorrhage. The authors present an unusual case of a hemorrhagic lymphangioma in a 1-year-old male child. The lesion originated in the mediastinum and extended into the cervicothoracic epidural space via a neural foramen. This resulted in an acute epidural hematoma and quadriparesis. Emergency decompression resulted in full neurological recovery. This may be the first report of a lymphangioma resulting in an acute epidural hematoma and quadriparesis.

Abbreviation used in this paper: MR = magnetic resonance.

Article Information

Address correspondence to: Jean-Paul Wolinsky, M.D., Department of Neurosurgery, Johns Hopkins University, Meyer 7-109, 600 North Wolfe Street, Baltimore, Maryland 21287. email: jwolins3@jhmi.edu.

© AANS, except where prohibited by US copyright law.

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Figures

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    Sagittal T1-weighted MR image demonstrating the C5–T2 epidural lesion.

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    Spinal decompression postoperative T2-weighted MR images in the patient. Left: Right parasagittal image of the mediastinal lymphangioma, which communicates with the epidural space through the right T2–3 neural foramen. Right: Axial image showing the tumor encroaching upon the neural foramen.

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    Photomicrograph of the operative tumor specimen showing the cavernous vascular channels of the lymphangioma. H & E, original magnification × 200.

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