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Hemophilic pseudotumor of the first lumbar vertebra.

Nachimuthu G, Arockiaraj J, Krishnan V, Sundararaj GD - Indian J Orthop (2014)

Bottom Line: Excision of pseudotumor was successfully carried out with additional spinal stabilization.At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status.Surgical excision gives satisfactory outcome in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.

No MeSH data available.


Related in: MedlinePlus

Preoperative T2 weighted (a) sagittal (b) coronal and (c) axial magnetic resonance images of pseudotumor showing craniocaudal extension of cyst and cranially displaced kidney
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Figure 2: Preoperative T2 weighted (a) sagittal (b) coronal and (c) axial magnetic resonance images of pseudotumor showing craniocaudal extension of cyst and cranially displaced kidney

Mentions: Magnetic resonance imaging (MRI) revealed a large cystic mass involving the left iliopsoas muscle, extending from L1 vertebral body into the left side of the pelvic cavity, the walls of which were thick and hypo intense suggestive of hemosiderin deposits. Intraosseous pseudotumor of L1 vertebra with partial collapse and destruction of most of the body and left pedicle, lamina and spinous process was seen. Pseudotumor arising from L1 vertebral body with extension into the epidural space and bilateral neural foramen leading to severe compression of dural sac and exiting nerve roots was noted [Figure 2a-c].


Hemophilic pseudotumor of the first lumbar vertebra.

Nachimuthu G, Arockiaraj J, Krishnan V, Sundararaj GD - Indian J Orthop (2014)

Preoperative T2 weighted (a) sagittal (b) coronal and (c) axial magnetic resonance images of pseudotumor showing craniocaudal extension of cyst and cranially displaced kidney
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232833&req=5

Figure 2: Preoperative T2 weighted (a) sagittal (b) coronal and (c) axial magnetic resonance images of pseudotumor showing craniocaudal extension of cyst and cranially displaced kidney
Mentions: Magnetic resonance imaging (MRI) revealed a large cystic mass involving the left iliopsoas muscle, extending from L1 vertebral body into the left side of the pelvic cavity, the walls of which were thick and hypo intense suggestive of hemosiderin deposits. Intraosseous pseudotumor of L1 vertebra with partial collapse and destruction of most of the body and left pedicle, lamina and spinous process was seen. Pseudotumor arising from L1 vertebral body with extension into the epidural space and bilateral neural foramen leading to severe compression of dural sac and exiting nerve roots was noted [Figure 2a-c].

Bottom Line: Excision of pseudotumor was successfully carried out with additional spinal stabilization.At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status.Surgical excision gives satisfactory outcome in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.

No MeSH data available.


Related in: MedlinePlus