Cervical intramedullary lipoma with unusual MRI features: case report

Intramedullary Spinal Cord Lipoma Mimicking a Late Subacute Hematoma

Spinal cord lipomas are rare and benign tumors which may cause progressive neurological deficits due to their local expansion. We present the case of a 59-year-old male patient with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images of the thoracic spine suggested a subacute intramedullary hematoma. Due to progression of the neurological deficit, the patient was referred to a neurosurgeon, who indicated surgical evacuation of the hematoma. The intraoperative finding revealed an intramedullary spinal cord lipoma, which was later confirmed by histological analysis. Since subacute intramedullary hematomas and intramedullary spinal cord lipomas present with similar clinical and radiological features, diffusion-weighted MR imaging should be used to distinguish these entities.

Intraspinal lipomas without associated spinal dysraphism

Introduction:

The aim of this study was to report surgical strategies and clinical outcomes for thoraco-lumbar intradural lipomas. Intraspinal lipomas are rare congenital histologically benign neoplasms, which account for less than 1% of all spinal cord tumors. These tumors are most frequently found in the lumbosacral area as components of a dysraphic state, however, intramedullary lipomas are not associated with spina bifida or cutaneous malformations and have only been described as isolated cases among spinal lipomas, where the thoracolumbar region is rarely affected.

Case Presentation:

Three patients with thoracolumbar intradural lipomas were admitted to our clinic at different points of time. Partial resections and debulking of the tumors were achieved with the guidance of an operating microscope. We performed laminectomies or laminoplasties, for tumor resections.

Discussion:

Postoperatively, the patients demonstrated significant clinical improvements. In this manuscript we presented our surgical experiences for intraspinal lipomas.

A rare case of intramedullary lipoma associated with cyst

Intramedullary lipomas are benign tumours of the spinal cord corresponding to 1% of all primitive intramedullary tumours. We report a rare case of "true" intramedullary lipoma associated with cyst. The patient underwent subtotal resection and the diagnosis was made by histopathological examination. There was postoperative neurological improvement.

Growth of intramedullary lipoma in a renal transplant recipient

BACKGROUND

Administration of glucocorticoids can lead to a variety of complications in addition to deposition of fat leading to cushingoid features. Corticosteroids, either endogenously produced or exogenously administered, are implicated in the growth of lipomas in different anatomic locations including the epidural space in the spinal cord causing cord compression.

METHOD

We report a growth of lipoma in an unusual site in a 28-year-old female renal transplant recipient within 6 weeks of renal transplant surgery.

RESULT

Our patient had an intradural lipoma that had merged with the medulla of the spinal cord making its total excision unfeasible without damaging the spinal cord.

CONCLUSION

Epidural lipomas causing cord compression is documented in patients receiving long-term corticosteroid therapy. This is the first case of intramedullary lipoma of the spinal cord that may be related to steroid use.