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Spinal intramedullary hamartoma with acute presentation in a 13-month old infant: case report
Eslam M Samak1, Assem M Abdel Latif1, Walid Abdel Ghany1
1Departments of 1 Neurological Surgery and.
Insights
Spinal cord hamartomas are rare tumors. This case highlights the importance of detailed imaging and pathology for diagnosis and management in children.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Pathology
Background:
- True spinal cord hamartomas are exceptionally rare neurological entities.
- Distinguishing them from other spinal cord lesions, particularly teratomas, can be challenging.
- Detailed radiological and pathological descriptions are scarce in existing literature.
Observation:
- A 13-month-old child presented with acute neurological decline and a supragluteal sacral dimple.
- Spinal Magnetic Resonance Imaging (MRI) revealed a large intramedullary lesion with heterogeneous signal intensity.
- Surgical intervention involved a near-total resection of the identified lesion.
Findings:
- Histopathological examination confirmed the lesion as a spinal cord hamartoma.
- The findings underscore the diagnostic difficulties and the need for precise pathological analysis.
- This case adds valuable data to the limited reports on spinal cord hamartomas.
Implications:
- Accurate preoperative evaluation, including advanced imaging, is crucial for suspected spinal cord hamartomas.
- Rigorous pathological examination is mandatory for definitive diagnosis and to guide treatment strategies.
- Improved understanding of spinal cord hamartomas can enhance patient management and outcomes in pediatric neurosurgery.
Abstract:
True hamartomas of the spinal cord are very rare, and although several have been reported in the literature, there are few detailed radiological and pathological descriptions of the condition. There is also considerable overlap with other entities, the most common being spinal cord teratomas. The authors report the case of a 13-month-old child with a supragluteal sacral dimple who presented with acute neurological deterioration. MRI of the spine revealed a big intramedullary lesion with heterogeneous signal intensity. A near-total resection was performed, and histopathological examination demonstrated findings consistent with a spinal cord hamartoma. The authors believe that careful preoperative evaluation and rigorous pathological examination are mandatory to establish diagnosis and direct further management of cases in which such a lesion is suspected.
