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King KA, Tsao T, Abdulrahim A, Hildenbrand A. A Case of Thoracic Epidural Angiolipoma Causing Severe Spinal Cord Compression With Neurologic Manifestations. Cureus 2023; 15:e45305. [PMID: 37720116 PMCID: PMC10503948 DOI: 10.7759/cureus.45305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
A spinal epidural angiolipoma is a rare, benign tumor of adipocytes and blood vessels that accounts only for a small percentage of all spinal axis tumors. We report a case of a 44-year-old male who presented with three months of progressive decreased sensation and strength from about six cm above the umbilicus down to his feet bilaterally. He presented to the emergency room when he could no longer walk. He also had neurogenic urinary retention and likely neurogenic constipation. Physical exam was notable for decreased sensation, decreased strength, and increased patellar reflexes bilaterally. MRI of the thoracic spine showed a posterior epidural mass that spanned from T2 to T3, measuring 1.2 x 1.7 x 4.3 cm, and severely compressed the spinal cord posteriorly. The patient underwent an urgent laminectomy for decompression and mass resection. Pathology was consistent with an angiolipoma. Postoperatively, he experienced a drastic improvement in strength and gross motor skills. The sensation had a partial return following surgery and continued to improve over the hospital stay. In general, the literature reports significant symptomatic improvement in patients with spinal epidural angiolipomas after surgical resection.
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Affiliation(s)
- Kali A King
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
| | - Tiffany Tsao
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
| | - Ahmed Abdulrahim
- Pathology and Laboratory Medicine, Creighton University School of Medicine, Omaha, USA
| | - Alec Hildenbrand
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
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Wang K, Shi L, Su Y, Wang H, Liu L. Clinical features and surgical outcomes of spinal epidural angiolipomas. Acta Neurol Belg 2023; 123:115-120. [PMID: 33948901 DOI: 10.1007/s13760-021-01689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Abstract
To discuss the clinical features and surgical outcomes of spinal epidural angiolipomas. We retrospectively analyzed the medical records of patients with spinal epidural angiolipomas who were performed microsurgery between January 2003 and December 2017. The diagnosis of spinal angiolipomas was based on pathological criteria. Modified McCormick classification was applied to evaluate neurological function. There were 11 females and 9 males with ages ranged from 38 to 74 years. Fourteen lesions were located in the thoracic region, 4 in the lumbar, 1 in the lumbosacral, and 1 in the thoracolumbar region. Patients presented with nonspecific symptoms and the duration of symptoms ranged from 1 to 168 months with a mean 21.3 months. 11 cases exhibited isointense on T1-weighted imaging(T1WI) and hyperintense on T2-weighted imaging(T2WI). The other 9 cases exhibited hyperintense on T1WI and T2WI imaging. Gross total resection (GTR) was performed in 19 patients, and subtotal resection (STR) was performed in 1 patient. Postoperatively, all patients showed a recovery or improvement of neurological functions except the STR patient. There was no recurrence or regrowth of the residual lesions observed on magnetic resonance images (MRI). Usually, spinal epidural angiolipomas have two types of MRI manifestations depending on the ratio of fat to vessels. Total resection of spinal epidural angiolipoma is possible regardless of it is infiltrative or not. Postoperative radiotherapy is not recommended for subtotal resection patients. A favorable functional outcome can be expected if the patient performed early surgery.
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Affiliation(s)
- Keda Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Liang Shi
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Yibing Su
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China.
| | - Hanbin Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Longqi Liu
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
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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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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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Spinal angiolipomas in pregnancy: Natural history and surgical treatment. Clin Neurol Neurosurg 2019; 178:25-30. [DOI: 10.1016/j.clineuro.2019.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/07/2019] [Accepted: 01/20/2019] [Indexed: 12/23/2022]
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Onishi FJ, Salem FAS, de Melo Lins DL, Dauar RFB, Stavale JN. Spinal thoracic extradural angiolipoma manifesting as acute onset of paraparesis: Case report and review of literature. Surg Neurol Int 2017; 8:150. [PMID: 28791193 PMCID: PMC5525459 DOI: 10.4103/sni.sni_467_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/22/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Angiolipomas are benign tumors most commonly found in the thoracic spine. They are composed of mature adipocytes and abnormal vascular elements that usually present with a slowly progressive course of neurological deterioration. CASE DESCRIPTION A 35-year-old female, with a prior history of back pain, acutely developed paraparesis. When the thoracic magnetic resonance imaging (MRI) revealed a dorsal epidural mass at the T3-T5 level, she underwent a laminectomy for gross total excision of the lesion that proved to be an angiolipoma. On the second postoperative day, the patient was again able to ambulate. CONCLUSION The angiolipomas of spine are rare causes of spinal cord compression, and those presenting with acute neurological deficits should be immediately treated.
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Mohammed Y, Elhamdani S, Farooq M, Mazagri R. A case report and review of thoracic spinal angiolipoma. Surg Neurol Int 2017; 8:113. [PMID: 28680732 PMCID: PMC5482159 DOI: 10.4103/sni.sni_148_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 05/05/2017] [Indexed: 11/04/2022] Open
Abstract
Background: While it is a rare entity, spinal angiolipomas are well-defined benign tumors that have been described sporadically in the literature starting from the late 1800s. Composed of mature lipomatous and angiomatous elements, these tumors manifest neurological symptoms due to progressive spinal cord or root compression. We present a case of a thoracic spinal angiolipoma and review the relevant literature. Case Description: A 68-year-old male with ongoing bilateral lower extremity weakness was found on enhanced magnetic resonance imaging to have an extradural mass in the thoracic spine causing cord compression. A T4–T8 laminectomy and complete excision of the epidural mass resulted in reversal of the patient's neurological symptoms. Histopathology identified the mass as a thoracic spinal angiolipoma. Conclusion: Given its uncommon occurrence and excellent prognosis, our report serves as a reminder to always consider spinal angiolipoma in the differential diagnosis of epidural masses.
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Affiliation(s)
- Yusif Mohammed
- Department of Neurosurgery, Marshall University Joan C. Edwards School of Medicine, West Virginia, USA
| | - Shahed Elhamdani
- Department of Neurosurgery, Marshall University Joan C. Edwards School of Medicine, West Virginia, USA
| | - Mobeen Farooq
- Department of Neurosurgery, Marshall University Joan C. Edwards School of Medicine, West Virginia, USA
| | - Rida Mazagri
- Department of Neurosurgery, Marshall University Joan C. Edwards School of Medicine, West Virginia, USA
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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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Periosteal chondroma with spinal cord compression in the thoracic spinal canal: a case report. Skeletal Radiol 2016; 45:1133-7. [PMID: 27179652 DOI: 10.1007/s00256-016-2406-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/15/2016] [Accepted: 05/03/2016] [Indexed: 02/02/2023]
Abstract
Periosteal chondroma is a very unusual cartilaginous neoplasm of the spinal canal. We herein report a case of periosteal chondroma in a 41-year-old male who presented with gait disturbance and paresthesia of both lower extremities. Magnetic resonance (MR) images showed an extradural mass which caused compression of the spinal cord at the T5/6 level. The mass showed iso-signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and nodular and peripheral rim enhancement on post-contrast T1-weighted images. Computed tomography (CT) images showed a mass with punctate calcifications and extension into the left T5/6 neural foramen. MR and CT images showed extrinsic cortical bone erosion of the posterior inferior body of T5 and superior pedicle of T6, bone remodeling with overhanging margins, and sclerosis adjacent to the tumor. The patient underwent a complete excision of the mass by left T5/6 hemi-laminectomy and exhibited complete resolution of his symptoms. Histopathologic examination revealed periosteal chondroma. Tumor recurrence was not recorded during the 18-month follow-up period.
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Wahle AM, Raith K, Posch B, Eddicks L, Matiasek K, Jurina K. IMAGING DIAGNOSIS-CONCENTRIC PERIRADICULAR LIPOMA CAUSING LUMBAR NERVE ROOT COMPRESSION IN A DOG. Vet Radiol Ultrasound 2016; 58:E6-E10. [PMID: 27147585 DOI: 10.1111/vru.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 02/29/2016] [Indexed: 11/29/2022] Open
Abstract
An 11-year-old, male neutered Jack Russell Terrier was presented with a nerve root signature of the right pelvic limb. Magnetic resonance imaging revealed a well demarcated, ovoid, extramedullary mass at the level of the L7 vertebral body. This showed, compared to normal spinal cord, hyperintense signal on T1- and T2-weighted images, which was suppressed on gradient echo short tau inversion recovery (GE-STIR) images. Additionally, the mass was characterized by a fat density on computed tomography images. Histopathology of the surgically excised mass was consistent with concentric periradicular lipoma, which has not been described in domestic animals yet.
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Affiliation(s)
- Andrea M Wahle
- Small Animal Clinic Haar, Section of Neurology, Haar, Germany
| | - Karina Raith
- Small Animal Clinic Haar, Section of Neurology, Haar, Germany
| | - Barbara Posch
- Small Animal Clinic Haar, Section of Diagnostic Imaging, Haar, Germany
| | - Lina Eddicks
- Ludwig Maximilians University of Munich, Section of Clinical & Comparative Neuropathology, Institute of Veterinary Pathology, Munich, Germany
| | - Kaspar Matiasek
- Ludwig Maximilians University of Munich, Section of Clinical & Comparative Neuropathology, Institute of Veterinary Pathology, Munich, Germany
| | - Konrad Jurina
- Small Animal Clinic Haar, Section of Neurology, Haar, Germany
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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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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.
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Affiliation(s)
- Mustafa M Nadi
- Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada. E-mail:
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13
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Abstract
Patients with potential bone and soft tissue tumors can be challenging for orthopedic surgeons. Lesions that appear benign can still create anxiety for the clinician and patient. However, attention to a few key imaging and clinical findings is enough to correctly diagnose five of the most common bone and soft tissue lesions: lipoma, enchondroma, osteochondroma, nonossifying fibroma, and Paget disease. Accurate identification of these lesions should be within the scope of most orthopedic surgeons and, because most of these patients will not need surgical treatment, referral to orthopedic oncology will not typically be required.
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Affiliation(s)
- Felasfa M Wodajo
- Musculoskeletal Tumor Surgery, Virginia Hospital Center, 1625 North George Mason, Suite 464, Arlington, VA 22205-3698, USA; Orthopedic Surgery, Georgetown University, Washington, DC, USA; Orthopedic Surgery, VCU School of Medicine, Inova Campus, VA 22205, USA.
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14
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Bovier EG, Gardino E, Chemes LN, Nogueira F, Romero VD. Acute paraplegia by spinal angiolipoma. Case report and literature review. COLUNA/COLUMNA 2014. [DOI: 10.1590/s1808-18512014130200403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Spinal angiolipoma is an uncommon form of benign tumor. There are 142 reported cases and only one of acute paraplegia. We describe a case of a 39 year old male with acute spinal paraplegia angiolipoma in T4-T5 with surgical resolution three weeks after the onset of the neurological syndrome. Postoperative neurologic recovery was complete. The angiolipoma consists of mature fat cells and abnormal blood vessels. There are 2 types: non-infiltrating and infiltrating. Its clinical course is slow and progressive, it can be accelerated by vascular phenomena, intratumoral abscess, and pregnancy. There is just one report of spontaneous intratumoral hemorrhage and acute paraplegia, coinciding with our case. There is no consensus as to treatment, and release and complete resection are suggested, as it is a disease with good prognosis. Angiolipoma spinal epidural is a rare form of benign tumor, and the treatment of this pathology continues to be release and resection of the tumor, with a favorable prognosis, despite the delay in surgery, as in the case reported. Intratumoral bleeding should be considered a cause of acute spinal compression syndrome, as ocurred in our patient.
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