Pacinioma of the cauda equina

Area of Science:

• Neuroscience
• Developmental Biology
• Pathology

Background:

• Pacinian corpuscles are mechanoreceptors typically found in peripheral nerves.
• Lesions involving Pacinian corpuscles are often associated with benign peripheral nerve tumors or reactive processes.
• Mature Pacinian corpuscles have been infrequently observed within intraspinal lumbosacral lipomas, a rare developmental anomaly linked to spina bifida.

Observation:

• A 5-month-old male presented with a sacral red papula and a lesion of the cauda equina containing numerous mature Pacinian corpuscles and nerve fascicles within adipose tissue.
• Magnetic resonance imaging (MRI) revealed a cord-like mass extending from the subcutis through a bone defect into the lumbosacral spinal canal.
• The mass ran intradurally, parallel to the cauda equina, terminating at the conus medullaris, with a low-lying, tethered spinal cord but no neurological deficit.

Findings:

• Surgical exploration confirmed a cord of yellow tissue originating from the subcutis and extending into the spinal canal.
• Histopathological examination revealed clusters of Pacinian corpuscles and nerve fascicles within adipose tissue.
• The child exhibited normal motor development fifteen months post-surgery.

Implications:

• This case may represent a rare variant of complex intraspinal lumbosacral lipomas, potentially related to previously reported 'Paciniomas'.
• The findings contribute to understanding the spectrum of congenital spinal anomalies involving Pacinian corpuscles and lipomas.
• Early surgical intervention in such cases appears to lead to favorable developmental outcomes.