Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Spinal Extradural Meningeal Cyst in Klippel-Trenaunay Syndrome

  • Choi, Kyung-Chul (Department of Neurosurgery, Daegu Wooridul Spine Hospital) ;
  • Ahn, Sung-Tae (Department of Neurosurgery, Daegu Wooridul Spine Hospital) ;
  • Shin, Yong-Hawn (Department of Neurosurgery, Daegu Wooridul Spine Hospital) ;
  • Lee, Sang-Ho (Department of Neurosurgery, Wooridul Spine Hospital)
  • Received : 2010.08.18
  • Accepted : 2011.04.18
  • Published : 2011.05.28
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Abstract

A case of a symptomatic spinal extradural meningeal cyst (SEMC) in Klippel-Trenaunay syndrome (KTS) is introduced. A 38-year-old woman presented with right L2 radiculopathy. She underwent operations for varicose veins in both her lower extremities. She had port-wine nevi on her trunk and extremities. The edematous change in both legs had waxed and waned. Magnetic resonance imaging showed an $11.8{\times}13$ mm extradural meningeal cyst growing through the intervertebral foramen in L2-3. Multiple meningeal cysts were located in the dorsal aspect of the spinal cord from T3 to T10. A $5.8{\times}6.2$ mm cyst was also found in left pleural cavity. The extradural meningeal cyst was completely excised and the preoperative symptom was improved. KTS is a congenital disorder due to a mesodermal abnormality, which may predispose the dura to weakness. The SEMC may occur through the dural defect or weakened point.

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References

  1. Alexander MJ, Grossi PM, Spetzler RF, McDougall CG : Extradural thoracic arteriovenous malformation in a patient with Klippel-Trenaunay-Weber syndrome : case report. Neurosurgery 51 : 1275-1278; discussion 1278-1279, 2002 https://doi.org/10.1097/00006123-200211000-00025
  2. Alvisi C, Cerisoli M, Giulioni M, Guerra L : Long-term results of surgically treated congenital intradural spinal arachnoid cysts. J Neurosurg 67 : 333-335, 1987 https://doi.org/10.3171/jns.1987.67.3.0333
  3. Baskerville PA, Ackroyd JS, Browse NL : The etiology of the Klippel-Trenaunay syndrome. Ann Surg 202 : 624-627, 1985 https://doi.org/10.1097/00000658-198511000-00015
  4. Bergland RM : Congenital intraspinal extradural cyst. Report of three cases in one family. J Neurosurg 28 : 495-499, 1968 https://doi.org/10.3171/jns.1968.28.5.0495
  5. Chynn KY : Congenital spinal extradural cyst in two siblings. Am J Roentgenol Radium Ther Nucl Med 101 : 204-215, 1967 https://doi.org/10.2214/ajr.101.1.204
  6. Cloward RB : Congenital spinal extradural cysts : case report with review of literature. Ann Surg 168 : 851-864, 1968 https://doi.org/10.1097/00000658-196811000-00011
  7. Cloward RB, Bucy PC : Spinal extradural cyst and kyphosis dorsalis juvenilis. 1937. Surg Neurol 39 : 469-473, 1993 https://doi.org/10.1016/0090-3019(93)90033-W
  8. Djindjian M, Djindjian R, Hurth M, Rey A, Houdart R : [Medullary angiomas and the Klippel-Trenaunay-Weber syndrome.] Rev Neurol (Paris) 133 : 609-619, 1977
  9. Durmaz R, Oztürk Z, Delen E, Ciftçi E, Atasoy MA : Symptomatic foraminal extradural meningeal cyst. Turk Neurosurg 19 : 91-95, 2009
  10. Elsberg CA, Dyke CG, Brewer ED : Symptoms and diagnosis of extradural cysts. Bull Neurol Inst NY 3 : 395-417, 1934
  11. Gortvai P, el-Gindi S : Spinal extradural cyst. Case report. J Neurosurg 26 : 432-435, 1967 https://doi.org/10.3171/jns.1967.26.4.0432
  12. Hatashita S, Kondo A, Shimizu T, Kurosu A, Ueno H : Spinal extradural achanoid cyst. Neurol Med Chir (Tokyo) 41 : 318-321, 2001 https://doi.org/10.2176/nmc.41.318
  13. Jacob AG, Driscoll DJ, Shaughnessy WJ, Stanson AW, Clay RP, Gloviczki P : Klippel-Trenaunay syndrome : spectrum and management. Mayo Clin Proc 73 : 28-36, 1998 https://doi.org/10.1016/S0025-6196(11)63615-X
  14. Kanaan IN, Sakati N, Otaibi F : Type I congenital multiple intraspinal extradural cysts associated with distichiasis and lymphedema syndrome. Surg Neurol 65 : 162-166, 2006 https://doi.org/10.1016/j.surneu.2005.05.013
  15. Kendall BE, Valentine AR, Keis B : Spinal arachnoid cysts : clinical and radiological correlation with prognosis. Neuroradiology 22 : 225-234, 1982 https://doi.org/10.1007/BF00342069
  16. Klippel M, Trenaunay P : Du noevus variqueux ostéo-hypertrophique. Arch Gen Med (Paris) 185 : 641-672, 1900
  17. Lombardi V : Post-operative subdural hematoma with associated extradural arachnoid cyst of spine. Case report. Acta Neurol (Napoli) 25 : 123-125, 1970
  18. McCrum C, Williams B : Spinal extradural arachnoid pouches. Report of two cases. J Neurosurg 57 : 849-852, 1982 https://doi.org/10.3171/jns.1982.57.6.0849
  19. Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, et al. : Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 68 : 366-377, 1988 https://doi.org/10.3171/jns.1988.68.3.0366
  20. Nugent GR, Odom GL, Woodhall B : Spinal extradural cysts. Neurology 9 : 397-406, 1959 https://doi.org/10.1212/WNL.9.6.397
  21. Phillips GN, Gordon DH, Martin EC, Haller JO, Casarella W : The Klippel-Trenaunay syndrome : clinical and radiological aspects. Radiology 128 : 429-434, 1978
  22. Rabb CH, McComb JG, Raffel C, Kennedy JG : Spinal arachnoid cysts in the pediatric age group : an association with neural tube defects. J Neurosurg 77 : 369-372, 1992 https://doi.org/10.3171/jns.1992.77.3.0369
  23. Robinson Y, Reinke M, Haschtmann D, Ertel W, Heyde CE : Spinal extradural meningeal cyst with spinal stenosis. Spinal Cord 44 : 457-460, 2006
  24. Rohrer DC, Burchiel KJ, Gruber DP : Intraspinal extradural meningeal cyst demonstrating ball-valve mechanism of formation. Case report. J Neurosurg 78 : 122-125, 1993 https://doi.org/10.3171/jns.1993.78.1.0122
  25. Stephan MJ, Hall BD, Smith DW, Cohen MM Jr : Macrocephaly in association with unusual cutaneous angiomatosis. J Pediatr 87 : 353-359, 1975 https://doi.org/10.1016/S0022-3476(75)80634-2
  26. Uemura K, Yoshizawa T, Matsumura A, Asakawa H, Nakamagoe K, Nose T : Spinal extradural meningeal cyst. Case report. J Neurosurg 85 : 354-356, 1996 https://doi.org/10.3171/jns.1996.85.2.0354
  27. Young AE : Congenital mixed vascular deformities of the limbs and their associated lesions. Birth Defects Orig Artic Ser 14 : 289-296, 1978

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