1
|
Spinal extradural angiolipomas: 7 new cases and review of the literature. NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2018.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
2
|
Carrasco Moro R, Gutiérrez Cierco JA, Martínez San Millán JS, Pian H, Martínez Rodrigo MA. Spinal extradural angiolipomas: 7 new cases and review of the literature. Neurologia 2017; 34:98-104. [PMID: 28081976 DOI: 10.1016/j.nrl.2016.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/10/2016] [Accepted: 11/12/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION We present our experience with the diagnosis and treatment of spinal angiolipomas (SAL). METHODS We used our database of surgical patients to gather epidemiological, clinical, diagnostic, treatment, and follow-up data from confirmed cases of SAL. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score for thoracic myelopathy. RESULTS We included 7 patients with ages ranging between 42 and 63 years; 4 were women. Lesions in all patients were located in the thoracic epidural space; in 2 cases, lesions extended outside the spinal canal. The most frequent form of presentation was pain combined with progressive myelopathy; patients scored 5 to 9 points on the mJOA scale. Radiological findings varied; this variability clearly depended on the proportion of tumour components (cellular variant in one case, predominantly angiomatous in another, and myxoid in yet another case). Four cases displayed radiological signs of bone involvement. Surgery resulted in excellent mJOA scores except in one case (mJOA score of 10); no recurrences were detected during follow-up (periods ranging from 1 to 5 years). CONCLUSIONS Extradural SAL can present with highly variable radiological and clinical features. Surgery must be tailored to each individual situation according to tumour extension; in some cases, it may include spinal reconstruction. Surgery results in excellent outcomes regardless of preoperative functional status and it is associated with low recurrence rates, even in case of incomplete resection.
Collapse
Affiliation(s)
- R Carrasco Moro
- Servicio de Neurocirugía, Hospital Universitario Ramón y Cajal, Madrid, España.
| | | | | | - H Pian
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, España
| | | |
Collapse
|
3
|
Isla A, Ortega Martinez R, Pérez López C, Gómez de la Riva A, Mansilla B. [Lumbar spinal angiolipoma]. Neurocirugia (Astur) 2016; 27:258-62. [PMID: 27263067 DOI: 10.1016/j.neucir.2016.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/26/2016] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
Spinal angiolipomas are fairly infrequent benign tumours that are usually located in the epidural space of the thoracic column and represent 0.14% to 1.3% of all spinal tumours. Lumbar angiolipomas are extremely rare, representing only 9.6% of all spinal extradural angiolipomas. We report the case of a woman who complained of a lumbar pain of several months duration with no neurological focality and that had intensified in the last three days without her having had any injury or made a physical effort. The MR revealed an extradural mass L1-L2, on the posterior face of the medulla, decreasing the anteroposterior diameter of the canal. The patient symptoms improved after surgery. Total extirpation of the lesion is possible in most cases, and the prognosis is excellent even if the lesion is infiltrative. For this reason, excessively aggressive surgery is not necessary to obtain complete resection.
Collapse
Affiliation(s)
- Alberto Isla
- Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
| | | | | | | | - Beatriz Mansilla
- Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España
| |
Collapse
|
4
|
Bouali S, Maatar N, Bouhoula A, Abderrahmen K, Said IB, Boubaker A, Kallel J, Jemel H. Spinal epidural angiolipomas: Clinical characteristics, management and outcomes. Asian J Neurosurg 2016; 11:348-351. [PMID: 27695535 PMCID: PMC4974956 DOI: 10.4103/1793-5482.180901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The spinal epidural angiolipomas are rare expansive processes made of mature lipomatous and angiomatous elements. They often have a benign character. Their etiology, pathogenesis remains uncertain, and it is a cause of spinal cord compression. The magnetic resonance imaging is the most important neuroradiological examination. Histological examination is the only examination to confirm the diagnosis. Surgery is the treatment of choice. METHODS A retrospective study of all patients operated on for a spinal epidural angiolipoma at the Department of Neurosurgery at the National Institute of Neurology of Tunis between January 2000 and December 2014 (15 years) was performed. The aim of this study is to describe the clinical, radiological, histological characteristics and the treatment of this tumor. RESULTS A total of nine patients were operated from January 01, 2000 to November 30, 2014. The average age of our patients was 51 years with ages that ranged from 29 to 65 with a male predominance. The period between onset of symptoms and diagnosis ranged from 24 months with an average 12 months. Posterior localization of the tumor was seen in all patients. Surgical resection was performed for all cases. The postoperative course has been satisfactory, with a complete recovery of neurological functions in all patients. CONCLUSIONS The spinal epidural angiolipomas is rare expansive process causing spinal cord compression. Treatment is exclusively surgical resection. The functional outcome of spinal epidural angiolipomas is particularly favorable with a complete neurological recovery is if the patient was quickly operated.
Collapse
Affiliation(s)
- Sofiene Bouali
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Nidhal Maatar
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Asma Bouhoula
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Khansa Abderrahmen
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Imed Ben Said
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Adnen Boubaker
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Jalel Kallel
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Hafedh Jemel
- Department of Neurosurgery, National Institute of Neurology "Mongi Ben Hmida", Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
5
|
Benvenutti-Regato M, De la Garza-Ramos R, Caro-Osorio E. Thoracic epidural spinal angiolipoma with coexisting lumbar spinal stenosis: Case report and review of the literature. Int J Spine Surg 2015; 9:67. [PMID: 26767159 PMCID: PMC4710163 DOI: 10.14444/2067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Spinal angiolipomas (SALs) are uncommon benign lesions that may present insidiously with back pain or acutely with weakness due to tumor bleeding/thrombosis. Given their rarity, these lesions are often overlooked in the differential diagnosis of epidural masses. The purpose of this article is to report the case of an epidural SAL and to conduct a literature review on the topic. METHODS A case report and review of the literature using the PubMed/Medline databases. All case reports and case series were reviewed up to June 2015. RESULTS A 65-year old female presented with neurogenic claudication and magnetic resonance imaging (MRI) revealed lumbar spinal stenosis. Following decompressive surgery, she experienced symptom resolution, but three months postoperatively she presented to the emergency department with acute paraparesis. A thoracic MRI revealed a lesion located between T8 and T10 causing severe spinal cord compression. Following emergent laminectomy and en bloc resection, the patient regained function and the lesion was diagnosed as SAL. Our literature review revealed 178 reported cases, with a female and thoracic predominance. The majority of patients underwent surgical treatment, achieving a gross total resection in most cases. Similarly, complete symptom resolution was the most common outcome. CONCLUSION Spinal angiolipomas are uncommon spinal tumors. However, they may be treated as any other space-occupying lesion, and surgical resection allows for complete symptom recovery in most patients.
Collapse
Affiliation(s)
- Mario Benvenutti-Regato
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
| | - Rafael De la Garza-Ramos
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
| | - Enrique Caro-Osorio
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
| |
Collapse
|
6
|
Abstract
Angiolipomas of the spine are rare benign tumors commonly presenting with compressive myelopathy. The present report describes a case of spinal angiolipoma with thoracic mediastinal extension in a 50-year-old woman. She presented with a long-standing history of mid-back pain with progressive lower extremities weakness. An MRI showed a heterogeneously enhancing mass located in the posterior epidural space of the thoracic spine with mediastinal extension. Histopathological examination demonstrated features consistent with spinal angiolipoma. This report emphasizes the diagnosis and therapeutic management options of infiltrating spinal angiolipomas.
Collapse
Affiliation(s)
- Mustafa M Nadi
- Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada. E-mail:
| | | | | | | |
Collapse
|
7
|
Spinal extradural angiolipoma: report of two cases and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2009; 18:324-35. [PMID: 19127373 DOI: 10.1007/s00586-008-0858-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 10/26/2008] [Accepted: 12/10/2008] [Indexed: 10/21/2022]
Abstract
Spinal angiolipomas are benign uncommon neoplasm composed of mature lipocytes admixed with abnormal blood vessels. They account for only 0.04-1.2% of all spinal tumors. We report two cases of lumbar extradural angiolipoma and review previously reported cases. We found 118 cases of spinal epidural angiolipoma (70 females and 48 males; age range 1.5-85 years, mean 44.03) spanning from 1890 to 2006. Prior to diagnosis 40.6% of the patients had weakness of the lower limbs. The interval between the initial symptoms and tumor diagnosis ranged from 1 day to 17 years (mean 20.2 months). Except for four cases diagnosed at autopsy, 109 patients underwent surgery and gross-total resection was performed in 79 cases (72.4%). Spinal angiolipomas are tumors containing angiomatous and lipomatous tissue, predominantly located in the mid-thoracic region. All angiolipomas show iso- or hyperintensity on T1-weighted images and hyperintensity on T2-weighted images and most lesions enhance with gadolinium administration. The treatment for spinal extradural angiolipomas is total surgical resection and no adjuvant therapy should be administered.
Collapse
|
8
|
Nanassis K, Tsitsopoulos P, Marinopoulos D, Mintelis A, Tsitsopoulos P. Lumbar spinal epidural angiolipoma. J Clin Neurosci 2008; 15:460-3. [DOI: 10.1016/j.jocn.2006.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 11/03/2006] [Accepted: 11/08/2006] [Indexed: 10/22/2022]
|
9
|
Urculo E, Samprón N, Alfaro R, Arrazola M, Linazasoro G. Compresión medular por lipoma epidural dorsal. Neurocirugia (Astur) 2008. [DOI: 10.1016/s1130-1473(08)70239-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
10
|
Dogan S, Arslan E, Sahin S, Aksoy K, Aker S. Lumbar spinal extradural angiolipomas. Two case reports. Neurol Med Chir (Tokyo) 2006; 46:157-60. [PMID: 16565587 DOI: 10.2176/nmc.46.157] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Spinal extradural angiolipomas are benign tumors mostly localized in the thoracic region. A 50-year-old woman and a 36-year-old man presented with rare lumbar spinal angiolipoma manifesting as low back pain but without neurological signs. Magnetic resonance imaging showed lumbar extradural tumors at the L4-5 and L1-2 levels, respectively. Each patient underwent complete surgical resection of the epidural tumors. Histological examination revealed characteristics of angiolipomas in both tumors. The symptoms of both patients improved postoperatively and no recurrence of the tumors was found 1 year after surgery.
Collapse
Affiliation(s)
- Seref Dogan
- Department of Neurosurgery, Uludag University Medical Faculty, Bursa, Turkey.
| | | | | | | | | |
Collapse
|
11
|
Konya D, Ozgen S, Kurtkaya O, Pamir NM. Lumbar spinal angiolipoma: case report and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2005; 15:1025-8. [PMID: 16172903 PMCID: PMC3489428 DOI: 10.1007/s00586-005-1028-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2005] [Revised: 08/14/2005] [Accepted: 08/21/2005] [Indexed: 12/22/2022]
Abstract
Spinal angiolipomas are extremely rare benign tumors composed of mature lipomatous and angiomatous elements. Most are symptomatic due to progressive spinal cord or root compression. This article describes the case of a 60-year-old woman who presented with a 6-month history of low back pain radiating to her right leg. The pain was multisegmental. The condition had worsened with time. Lumbar magnetic resonance imaging revealed a dorsal epidural mass at L5 and erosion of the lamina of the L5 vertebra. Laminectomy was performed, and an extradural tumor was totally excised. Neuropathologic examination identified it as a lumbar spinal angiolipoma. There was no evidence of recurrence in follow-up 12 months later. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion.
Collapse
Affiliation(s)
- Deniz Konya
- Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey.
| | | | | | | |
Collapse
|