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Sun M, Tao B, Gao G, Shang A. Tethered Cord Syndrome Associated with Spina Bifida and Intradural Angiolipoma Coexisting with Intramedullary Arteriovenous Malformation. Clin Neuroradiol 2022; 32:1127-1130. [PMID: 35041010 DOI: 10.1007/s00062-021-01136-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 12/23/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Mengchun Sun
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.,Medical School, Nankai University, 94 Weijin Road, Nankai District, Tianjin, China
| | - Benzhang Tao
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.,Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Gan Gao
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Aijia Shang
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.
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2
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Umana GE, Visocchi M, Roca E, Passanisi M, Fricia M, Tranchina MG, Tomasi SO, Nicoletti GF, Cicero S, Scalia G. Thoracic Spinal Angiolipomas: A Systematic Review. J Neurol Surg A Cent Eur Neurosurg 2021; 83:161-172. [PMID: 34929751 DOI: 10.1055/s-0041-1739217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Spinal angiolipomas (SAs) are rare, benign tumors, representing 0.0004 to 1.2% of angiolipomas, usually located at the extradural and posterior thoracic level, with multimetameric extension. METHODS A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched on PubMed and Scopus databases for published articles with the Mesh term "spinal angiolipoma" and pertinent associations. Language restriction to English papers was applied. The authors also reported three emblematic cases of patients who underwent surgical resection of spindle-shaped (type IA) and dumbbell-shaped (type II) SAs between 2014 and 2020. RESULTS Of the 256 retrieved articles, 33 were included in the meta-analysis. These 33 studies, together with our 3 reported cases, included a total of 60 patients, 36 females (60%) and 24 males (40%), with a mean age of 53.12 ± 12.82 years (range: 12-77 years).T5 was the most represented level (22 patients). Usually, the localization of SA was extradural, with 53 patients suffering from spindle-shaped type IA SA (88.3%) and 7 patients from dumbbell-shaped type II SA (11.6%). Almost all patients underwent laminectomy (78.3%) and presented a full recovery of motor deficits (85%). Gross total removal (GTR) was performed in 93.3% of patients. The mean follow-up was of 22.71 ± 21.45 months (range: 2-80 months). There was no documented recurrence at follow-up magnetic resonance imaging in any of the patients. CONCLUSIONS SAs are rare, benign tumors with a great vascular component that presents a favorable outcome. GTR is the gold standard treatment and usually an adjuvant therapy is not required. Even infiltrative lesions, which are more complex, can be treated successfully with a good prognosis. Dumbbell-shaped SAs must be differentiated from schwannomas and meningiomas, and require different surgical techniques, given the profuse bleeding associated with the attempt of debulking. En block resection is the key to treat these common benign tumors with acceptable blood loss.
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Affiliation(s)
| | - Massimiliano Visocchi
- Department of Neurosurgery, Policlinico Universitario Agostino Gemelli, Roma, Lazio, Italy.,Catholic University of the Sacred Heart Rome Campus, Roma, Italy
| | - Elena Roca
- Department of Neurosurgery, Head and Neck Surgery, Poliambulanza Foundation Hospitals, Brescia, Lombardia, Italy
| | - Maurizio Passanisi
- Department of Neurosurgery, Azienda Ospedaliera Cannizzaro, Catania, Sicilia, Italy
| | - Marco Fricia
- Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
| | | | | | | | | | - Gianluca Scalia
- Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy
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3
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Yang T, Niu C. Microsurgical treatment for spinal epidural angiolipomas. Acta Neurol Belg 2021; 121:421-427. [PMID: 31309454 DOI: 10.1007/s13760-019-01192-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
Spinal epidural angiolipomas are rare lesions composed of mature lipomatous and angiomatous elements. In this paper, the authors review a surgical series of ten patients with epidural angiolipomas. All patients had performed preoperative and postoperative magnetic resonance imaging. The diagnosis of angiolipoma was based on pathology. All the follow-up data were obtained during office visits. There were 5 males and 5 females with a mean age of 53.6 years. One tumor was located in the cervicothoracic, six in the thoracic, and three in the lumbar spine. The most common symptom was progressive motor deficit. Gross total resection of the tumor was achieved in nine cases, and subtotal resection was obtained in one case. No recurrence or regrowth of the residual tumor was observed during a follow-up period of 50.8 months. At the last follow-up, 90% of patients experienced improvement in the neurological function. Epidural angiolipomas are benign but clinically progressive lesions. Early surgery should be performed to prevent irreversible neurological deficits. Postoperative radiotherapy is not recommended. The risk of long-term recurrence/regrowth of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected.
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Affiliation(s)
- Tao Yang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China
| | - ChaoShi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China.
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Jaiswal PA, Divakar G, Krishnakumar K, Karthikayan A, Sawakare Y, Mhatre R, Abraham M. Spinal angiolipoma-a rare but reversible cause of paraplegia in a child. Childs Nerv Syst 2020; 36:1121-1125. [PMID: 32052158 DOI: 10.1007/s00381-020-04542-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Spinal angiolipomas are benign spinal epidural tumors consisting of mature fat cells with angiomatous components. These tumors are rare in children and there are no definite management guidelines. METHOD To the best of our knowledge, only five cases of spinal angiolipomas have been reported in children below 12 years. This article discusses the presentation, diagnostics, and surgical tips for the management of a case of spinal angiolipoma. RESULT In this paper, we present a one and half-year-old child presenting with a spontaneous spinal epidural hematoma from a spinal angiolipoma and underscore the importance of early surgery in a benign disease for a good outcome. CONCLUSION Overall neurological recovery and prognosis following timely intervention for spinal angiolipomas are good.
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Affiliation(s)
- Palak A Jaiswal
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Ganesh Divakar
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India.
| | - K Krishnakumar
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Arunkumar Karthikayan
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Yogesh Sawakare
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Radhika Mhatre
- Department of Pathology, National Institute of Mental Health and Neurosciences (NIMHANS), Benguluru, India
| | - Mathew Abraham
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
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Iampreechakul P, Tangviriyapaiboon T, Liengudom A, Lertbutsayanukul P, Thammachantha S, Siriwimonmas S. Sacral Extradural Angiolipoma Associated with Tight Filum Terminale and Spina Bifida Coexisting with Spinal Arteriovenous Fistula. World Neurosurg 2020; 140:37-45. [PMID: 32407913 DOI: 10.1016/j.wneu.2020.04.239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spinal arteriovenous fistula (AVF) may rarely associate with spinal dysraphism, that is, tethered spinal cord and spinal intradural lipoma. Spinal extradural angiolipoma coexisting with spinal AVF has not been reported in the literature. We reported an extremely rare case of sacral angiolipoma associated with tight filum terminale and sacral spina bifida coexisting with spinal AVF within this tumor. CASE DESCRIPTION A 55-year-old women presented with progressive myelopathy for 10 months. She had a painless, slow-growing mass at her left buttock since birth. Magnetic resonance imaging of the lumbosacral spine showed an extradural mass at the level of S3-S4, extending from the spinal canal through the spina bifida to the subcutaneous fat of the left buttock. There was a low conus medullaris at S2. Magnetic resonance imaging of the thoracic spine disclosed venous congestion with tortuous intradural flow voids along both ventral and dorsal surfaces of the spinal cord. Magnetic resonance angiography and spinal angiography revealed a hypervascular mass at the sacral level and associated arteriovenous shunt with cranial drainage into an enlarged medullary vein. Due to an infected pressure sore on the mass, endovascular treatment was initially performed with minimal recovery. Six months after complete healing of her infected pressure ulcer, the patient underwent surgical removal of extradural mass containing the AVF, and subsequent release of the tight filum. Histologic findings were consistent with angiolipoma. CONCLUSIONS Sacral extradural angiolipoma in the present case may be congenital in origin with development of an acquired spinal AVF within the tumor.
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Affiliation(s)
| | | | - Anusak Liengudom
- Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
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6
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Wang FF, Wang S, Xue WH, Cheng JL. Epidural spinal angiolipoma: a case series. BMC Res Notes 2017; 10:128. [PMID: 28320469 PMCID: PMC5359808 DOI: 10.1186/s13104-017-2432-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/16/2017] [Indexed: 12/27/2022] Open
Abstract
Background Spinal angiolipomas (SAL) are rare benign tumors, commonly presenting with slow progressive spinal cord compression. There are only about 170 cases identified so far. Magnetic resonance imaging (MRI) has become the modality of choice for SAL. The purpose of this article is to report three cases of SAL and their characteristic MRI features. Case presentation Three cases of epidual spinal angiolipoma from ethnic Han Chinese patients are presented here, including one lumbar and two thoracic tumors. MRI imaging findings were reviewed. Conclusions Multiple MRI technology for characterization of SAL provides useful information for differential diagnosis and therapeutic management.
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Affiliation(s)
- Fei Fei Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Song Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Wen Hua Xue
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Jing Liang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China.
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Shweikeh F, Sangtani A, Steinmetz MP, Zahos P, Chopko B. Spinal angiolipomas: A puzzling case and review of a rare entity. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2017; 8:91-96. [PMID: 28694590 PMCID: PMC5490357 DOI: 10.4103/jcvjs.jcvjs_23_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Patients with spinal epidural abscesses (SEAs) may have a variable presentation. Such an infection has a typical appearance on magnetic resonance imaging (MRI) and enhances with gadolinium. We present a case that was a diagnostic challenge where pre- and intra-operative findings resulted in conflicting impressions. The mimicker was a spinal angiolipoma (SAL). The authors then provide a thorough review of this rare spinal neoplasm. A 55-year-old man presented with back pain, paresis, paresthesia, and urinary retention. MRI was indicative of a longitudinal epidural thoracic mass with a signal homogeneous to nearby fat, curvilinear vessels, and lack of enhancement. Although at emergent surgery, the lesion was found to contain abundant purulent material. Microbiology was positive for methicillin-resistant Staphylococcus aureus and consistent with SEA without evidence of neoplasia. While the imaging features were suggestive of an angiolipoma, the findings at surgery made SEA more likely, which were validated histopathologically. The diagnosis of SEA is often clear-cut, and the literature has reported only a few instances in which it masqueraded as another process such as lymphoma or myelitis. The case highlights SEA masquerading as an angiolipoma, and further demonstrates to clinicians that obtaining tissue diagnosis plays a crucial role diagnostically and therapeutically. SALs, on the other hand, are slow-growing tumors that can be infiltrating or noninfiltrating. They typically present with chronic symptoms and T1-MRI shows an inhomogeneous picture. Complete surgical excision is standard of care and patients tend to do well afterward.
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Affiliation(s)
- Faris Shweikeh
- Summa Health System, Northeast Ohio Medical University, Rootstown, USA.,College of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Ajleeta Sangtani
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Michael P Steinmetz
- Department of Neurosurgery, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA
| | - Peter Zahos
- Department of Neurosurgery, New York Medical College, Valhalla, NY, USA
| | - Bohdan Chopko
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA.,Department of Neurosurgery, Stanford University, Palo Alto, CA, USA
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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.
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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
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9
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Sim K, Tsui A, Paldor I, Kaye AH, Gaillard F. Four cases of spinal epidural angiolipoma. J Clin Neurosci 2015; 25:134-9. [PMID: 26778809 DOI: 10.1016/j.jocn.2015.08.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/01/2015] [Accepted: 08/14/2015] [Indexed: 12/14/2022]
Abstract
Spinal angiolipomas are uncommon benign tumours composed of mature fatty tissue and abnormal vascular elements, most commonly found within the posterior spinal epidural space. Most tumours are located within the mid-thoracic spine; in contrast thoracolumbar junction and purely lumbar angiolipomas are rare. We report a case series of four spinal angiolipomas, including a thoracolumbar junction and a purely lumbar tumour.
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Affiliation(s)
- Kenneth Sim
- Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia.
| | - Alpha Tsui
- Department of Pathology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Iddo Paldor
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Andrew H Kaye
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Frank Gaillard
- Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia
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10
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Spinal cavernous extradural angiolipoma manifesting as a spontaneous spinal epidural hematoma in a child. Childs Nerv Syst 2015; 31:1223-6. [PMID: 26065860 DOI: 10.1007/s00381-015-2760-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Angiolipomas are benign tumors usually manifested as subcutaneous nodules. Rarely they may form spinal extradural masses. These spinal cavernous angiolipomas have mostly been described in adults. DIAGNOSIS To our knowledge, spinal cavernous angiolipomas have been reported in nine pediatric patients. CLINICAL PRESENTATION In this paper, we present a 1-year-old child presenting with a spontaneous spinal epidural hematoma from a spinal cavernous angiolipoma and highlight the importance of conducting a histopathological analysis of spontaneous hematomas in previously healthy children.
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Si Y, Wang Z, Pan Y, Lin G, Yu T. Spinal angiolipoma: etiology, imaging findings, classification, treatment, and prognosis. 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 2013; 23:417-25. [PMID: 24190280 DOI: 10.1007/s00586-013-3073-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 10/12/2013] [Accepted: 10/13/2013] [Indexed: 12/28/2022]
Abstract
PURPOSE To summarise our experience treating patients with spinal angiolipomas (SAs) and to evaluate factors relating to its prognosis. METHODS We retrospectively reviewed the records of patients diagnosed with SAs who received surgical treatment from January 2001 to February 2013. RESULTS Twenty-one patients were described. We divide SAs into two types: "intraspinal" and "dumbbell-shaped". The former were further subclassified as "with lipomatosis" and "without lipomatosis". Overweight people are more likely to get the "with lipomatosis" type which needs different surgical strategy and/or a diet therapy to get better outcomes. CONCLUSION Diagnosis of SAs should be made with reference to clinical, radiological, and pathological findings. Application of different methods is needed to treat SAs.
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Affiliation(s)
- Yu Si
- Department of Neurosurgery, Peking University Third Hospital, No. 49. North Garden Street, HaiDian District, Beijing, 100191, People's Republic of China,
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Thoracolumbar spinal angiolipoma demonstrating high signal on STIR imaging: a case report and review of the literature. Spine J 2013; 13:e1-5. [PMID: 24071036 DOI: 10.1016/j.spinee.2013.06.057] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 02/05/2013] [Accepted: 06/14/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND Angiolipomas are rare benign tumors, accounting for 0.14% to 1.2% of all tumors of the spinal axis with vascular and fatty histological features. Spinal angiolipoma (SAL) is most commonly found in the thoracic region and has high signal on contrast enhanced fat-saturated T1-weighted imaging. Although the international literature is extensive, there are few cases reported in United States. OBJECTIVE To present a case of SAL located in the thoracolumbar region without high signal on contrast enhanced fat-saturated T1-weighted imaging and to review previously reported cases. STUDY DESIGN/METHODS Case report and review the literature. RESULTS Magnetic resonance imaging obtained in a 68-year-old man with a long history of lumbago showed a heterogeneous mass (T10-L1) hyperintense on T1-weighted imaging but not enhancing on suppression fat sequences, suggesting epidural hematoma. Surgical excision of the lesion was performed, and SAL was diagnosed and confirmed by pathology. The patient became asymptomatic. CONCLUSIONS The predominance of either vascular or fatty components inside the tumor might alter the expected results on magnetic resonance imaging with suppression fat sequences.
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Meng J, Du Y, Yang HF, Hu FB, Huang YY, Li B, Zee CS. Thoracic epidural angiolipoma: A case report and review of the literature. World J Radiol 2013; 5:187-192. [PMID: 23671756 PMCID: PMC3647212 DOI: 10.4329/wjr.v5.i4.187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 12/18/2012] [Accepted: 01/21/2013] [Indexed: 02/06/2023] Open
Abstract
Angiolipoma of the spine is a benign neoplasm consisting of both mature fatty tissue and abnormal vascular elements, and usually presents with a slow progressive clinical course. Our patient presented with bilateral lower extremity weakness and chest-back numbness. Physical examination revealed adipose elements superficial hypesthesia below the T5 level and analgesia below the T6 level. Magnetic resonance imaging (MRI) scan showed an avidly and heterogeneously enhancing mass which was located in the posterior epidural space. Compression of the thoracic cord by the fusiform mass was seen between T3-T4. During the operation, a flesh pink vascular mass (4.7 cm × 1.0 cm × 1.0 cm) with obscure margin and strong but pliable texture was found in the posterior epidural space extending from T3 to T4. There was no infiltration of the dura or the adjacent bony spine. Histopathological study of the surgical specimen showed a typical angiolipoma. We review the previously documented cases of spinal extradural angiolipomas performed with MRI.
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