Pediatric Radiology

, Volume 42, Issue 3, pp 315–320 | Cite as

Spinal dysraphism associated with the cutaneous lumbosacral infantile hemangioma: a neuroradiological review

  • Wendy E. Schumacher
  • Beth A. Drolet
  • Mohit Maheshwari
  • Kimberly A. Horii
  • Amy J. Nopper
  • Brandon D. Newell
  • Denise W. Metry
  • Maria C. Garzon
  • Kimberly D. Morel
  • Sarah L. Chamlin
  • Anthony J. Mancini
  • Ilona J. Frieden
  • Craig M. Johnson
Original Article

Abstract

Background

Spinal dysraphism is suspected in patients with midline abnormalities, especially in those with lumbosacral cutaneous markings. A recent prospective study demonstrated that isolated cutaneous infantile hemangiomas (IH) of the lumbosacral region have one of the highest risks (relative risk of 438) of associated spinal dysraphism.

Objective

The specific types of dysraphism and radiological findings associated with cutaneous IH of the lumbosacral region have not been described in detail, to the best of our knowledge. The aim of this multicenter study is to retrospectively classify types of spinal anomalies associated with the cutaneous lumbosacral IH.

Materials and methods

The radiological images of 20 cases of lumbosacral infantile hemangioma associated with spinal dysraphism were reviewed.

Results

Tethered cord was found in 60% of the 20 cases, spinal lipoma was present in 50% and 45% had intraspinal hemangiomas. Sinus tract was found in 40% of the children.

Conclusion

A range of spinal anomalies is associated with cutaneous lumbosacral infantile hemangiomas and MRI can be used to characterize these abnormalities.

Keywords

Spinal dysraphism Hemangioma Children 

References

  1. 1.
    Drolet BA, Chamlin SL, Garzon MC et al (2010) Prospective study of spinal anomalies in children with infantile hemangiomas of the lumbosacral skin. J Pediatr 157:789–794PubMedCrossRefGoogle Scholar
  2. 2.
    Guggisberg D, Hadj-Rabia S, Viney C et al (2004) Skin markers of occult spinal dysraphism in children: a review of 54 cases. Arch Dermatol 140:1109–1115PubMedCrossRefGoogle Scholar
  3. 3.
    Goldberg NS, Hebert AA, Esterly NB (1986) Sacral hemangiomas and multiple congenital abnormalities. Arch Dermatol 122:684–687PubMedCrossRefGoogle Scholar
  4. 4.
    Albright AL, Gartner JC, Wiener ES (1989) Lumbar cutaneous hemangiomas as indicators of tethered spinal cords. Pediatrics 83:977–980PubMedGoogle Scholar
  5. 5.
    Girard C, Bigorre M, Guillot B et al (2006) PELVIS syndrome. Arch Dermatol 142:884–888PubMedCrossRefGoogle Scholar
  6. 6.
    Stockman A, Boralevi F, Taieb A et al (2007) SACRAL syndrome: spinal dysraphism, anogenital, cutaneous, renal and urologic anomalies, associated withangioma of lumbosacral localization. Dermatology 214:40–45PubMedCrossRefGoogle Scholar
  7. 7.
    Iaocobas I, Burrows PE, Frieden IJ et al (2010) LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. J Pediatr 157:795–801CrossRefGoogle Scholar
  8. 8.
    Kriss VM, Desai NS (1998) Occult spinal dysraphism in neonates: assessment of high risk cutaneous stigmata on sonography. AJR 171:1687–1692PubMedGoogle Scholar
  9. 9.
    Hoffman HJ, Hendrick EB, Humphreys RP (1976) The tethered spinal cord: its protean manifestations, diagnosis and surgical correction. Childs Brain 2:145–155PubMedGoogle Scholar
  10. 10.
    Yamada S, Won DJ, Pezeshkpour G et al (2007) Pathophysiology of tethered cord syndrome and similar complex disorders. Neurosurg Focus 23:E6PubMedCrossRefGoogle Scholar
  11. 11.
    Hajnovic L, Trnka J (2007) Tethered spinal cord syndrome—the importance of time for outcomes. Eur J Pediatr Surg 17:190–193PubMedCrossRefGoogle Scholar
  12. 12.
    Muthukumar N (2009) Congenital spinal lipomatous malformations. Part I-Classification. Acta Neurochir 151:179–188CrossRefGoogle Scholar
  13. 13.
    Muthukumar N (2009) Congenital spinal lipomatous malformations. Part II-Clinical presentation, operative findings, and outcome. Acta Neurochir 151:189–197CrossRefGoogle Scholar
  14. 14.
    Karikari IO, Selznick LA, Cummings TJ et al (2007) Spinal capillary hemangioma in infants: report of two cases and review of the literature. Pediatr Neurosurg 43:125–129PubMedCrossRefGoogle Scholar
  15. 15.
    Martinez-Niguez JF, Almagro MJ, Ferri-Niguez B et al (2011) Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities. Childs Nerv Syst 27:609–616CrossRefGoogle Scholar
  16. 16.
    Hess CP, Fullerton HJ, Metry DW et al (2010) Cervical and intracranial arterial anomalies in 70 patients with PHACE syndrome. AJNR 31:1980–1986PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Wendy E. Schumacher
    • 1
  • Beth A. Drolet
    • 1
  • Mohit Maheshwari
    • 2
  • Kimberly A. Horii
    • 3
  • Amy J. Nopper
    • 3
  • Brandon D. Newell
    • 3
  • Denise W. Metry
    • 4
  • Maria C. Garzon
    • 5
  • Kimberly D. Morel
    • 5
  • Sarah L. Chamlin
    • 6
  • Anthony J. Mancini
    • 6
  • Ilona J. Frieden
    • 7
  • Craig M. Johnson
    • 2
  1. 1.Departments of Dermatology and PediatricsChildren’s Hospital of Wisconsin, Medical College of WisconsinMilwaukeeUSA
  2. 2.Department of Pediatric RadiologyChildren’s Hospital of WisconsinMilwaukeeUSA
  3. 3.Section of DermatologyChildren’s Mercy Hospital and ClinicsKansas CityUSA
  4. 4.Department of DermatologyBaylor College of MedicineHoustonUSA
  5. 5.Departments of Dermatology and PediatricsColumbia UniversityNew YorkUSA
  6. 6.Departments of Pediatrics and Dermatology, Children’s Memorial HospitalFeinberg School of Medicine, Northwestern UniversityChicagoUSA
  7. 7.Department of DermatologyUniversity of California at San FranciscoSan FranciscoUSA

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