Akiko Hiraoka1, Takato Morioka2, Nobuya Murakami3, Satoshi O Suzuki4, Masahiro Mizoguchi5. 1. Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan. 2. Department of Neurosurgery, Fukuoka Children's Hospital, 5-1-1 Kashii-teriha, Higashi-ku, Fukuoka, 813-0017, Japan. takato@ns.med.kyushu-u.ac.jp. 3. Department of Neurosurgery, Fukuoka Children's Hospital, 5-1-1 Kashii-teriha, Higashi-ku, Fukuoka, 813-0017, Japan. 4. Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 5. Department of Neurosurgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
Abstract
BACKGROUND: Limited dorsal myeloschisis (LDM) is characterized by a fibroneural stalk linking the skin lesion to the underlying spinal cord. CASE PRESENTATION : A 7-month-old girl with a lumbosacral "cigarette-burn" flat skin lesion underwent untethering surgery. The intradural tethering stalk appeared to originate at the dural wall and join the cord with no extradural stalk linking to the skin lesion. Histological examination of the intradural stalk revealed glial fibrillary acidic protein-immunopositive neuroglial tissues in the fibrocollagenous band, which is the central histopathological feature of an LDM stalk. CONCLUSION: It is conceivable that the LDM stalk in our patient was originally linked to the skin lesion and subsequently regressed and was replaced by mature adipose tissue. We should be mindful of possible variations in the morphological features of LDM.
BACKGROUND: Limited dorsal myeloschisis (LDM) is characterized by a fibroneural stalk linking the skin lesion to the underlying spinal cord. CASE PRESENTATION : A 7-month-old girl with a lumbosacral "cigarette-burn" flat skin lesion underwent untethering surgery. The intradural tethering stalk appeared to originate at the dural wall and join the cord with no extradural stalk linking to the skin lesion. Histological examination of the intradural stalk revealed glial fibrillary acidic protein-immunopositive neuroglial tissues in the fibrocollagenous band, which is the central histopathological feature of an LDM stalk. CONCLUSION: It is conceivable that the LDM stalk in our patient was originally linked to the skin lesion and subsequently regressed and was replaced by mature adipose tissue. We should be mindful of possible variations in the morphological features of LDM.