[A case of neurofibromatosis with spinal dural ectasia and vertebral body scalloping: a case report]

A 41-year-old man noticed colorless cutaneous nodules all over his body at the age of 24. Recently the nodules increased markedly in number and several large nodules were removed at the dermatological clinic of our hospital. The histological diagnosis of the nodules was neurofibroma. He was then referred to our neurosurgical clinic for neurological examinations to rule out involvement of the central nervous system. He showed no abnormality in neurological examination except for hyper-reflexia of the left patellar tendon reflex and occasional right leg weakness. Cranial CT scan and EEG were normal. Mental examination and routine laboratory studies were also normal. Vertebral scoliosis from C6 to T3 level, enlargement of the bilateral vertebral foramen at the level of T2 to T4, vertebral dysplasia of the C6 and T3, and the scalloping of the vertebral posterior margin of the T2 to T4 were seen in the plain X-ray films and tomography of the upper thoracic and cervical spine. The myelography and metrizamide CT scan showed multiple diverticular dilation of CSF space at the level of T1 to T4. This extended through the enlarged vertebral foramina to the chest cavity forming a dumb-bell shape. Spinal cord was normal and there was no tumor in the spinal canal. Dural ectasia and vertebral body scalloping were more clearly shown by magnetic resonance imaging (M.R.I). Dural ectasia accompanying von Recklinghausen's disease is rare and no MRI findings have been reported. Therefore, we reported this case and mainly discussed roentgenological findings and MRI of dural ectasia and other spinal abnormalities.