Spinal Capillary Hemangioma with Intramedullary and Extramedullary Extension in a Child with Cutaneous Stigmata: A Rare Case

We report a rare case of a pediatric spinal capillary hemangioma with both intramedullary and extramedullary components in association with a dorsal cutaneous lesion. The patient, an 13-month-old girl, initially presented with a soft tissue mass on her lower back. MRI revealed a lesion extending from the conus medullaris to L4, initially misinterpreted as a mature teratoma. Due to the emergence of new urodynamic abnormalities, surgical exploration revealed a reddish-brown, moderately firm tumor with tethering of the spinal cord, which was partially resected under intraoperative neuromonitoring. Histopathological findings confirmed capillary hemangioma. To date, only 13 pediatric cases have been reported, and our case represents the first with combined intra- and extramedullary involvement and cutaneous stigmata. This case highlights the importance of including vascular tumors in the differential diagnosis of spinal dysraphism with skin markers and underscores the value of early surgical intervention to prevent neurological decline.