Epidural angiolipoma: A rare cause of spinal cord compression.
Int J Surg Case Rep 2018;
45:72-76. [PMID:
29573600 PMCID:
PMC6000995 DOI:
10.1016/j.ijscr.2018.03.005]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/23/2018] [Accepted: 03/11/2018] [Indexed: 11/22/2022] Open
Abstract
Spinal epidural angiolipoma is a rare cause of progressive spinal cord compression.
Magnetic resonance imaging is necessary for diagnosis.
Total resection is the treatment of choice.
Necessary precautions before and during surgery have to be taken (embolisation, transfusion).
Prognosis after surgical management is excellent even at the stage of complete paraplegia.
Introduction
Angiolipomas are benign, slow growing lesions, almost always located subcutaneously in the trunc or limbs. They are composed of mature lipocytes admixed with abnormal blood vessels. Spinal epidural angiolipoma are rare accounting for approximately 0.14–1.2% of all spinal axis tumors and 2–3% of epidural spinal tumors.
Presentation of case
We report the case of a 65 years-old-woman, presenting with complete paraplegia installed since 7 months. Magnetic resonance imaging (MRI) showed an epidural dorsal fatty mass. The patient recovered immediately after surgery. The pathological examination concluded to an angiolipoma.
Discussion
Angiolipoma patients most commonly have long-lasting pain and then develop progressive neurological symptoms secondary to spinal cord compression. The mean duration of symptom progression at diagnosis is 1 year. MRI is the most reliable examination for the diagnosis of spinal angiolipoma. Total resection is the treatment of choice. No adjuvant treatment is indicated.
Since SAL are very haemorrhagic lesions, preoperative embolization is recommended.
Conclusion
We think that spinal cord compression caused by angiolipoma have very good functional prognosis, even if tardily diagnosed
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