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Spinal Angiolipoma

Published online by Cambridge University Press:  02 March 2017

Daryl R. Fourney ,
Karen A. Tong ,
Robert J.B. Macaulay  and
Robert W. Griebel
Daryl R. Fourney*
Affiliation:
Division of Neurosurgery, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Karen A. Tong
Affiliation:
Department of Radiology, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Robert J.B. Macaulay
Affiliation:
Department of Pathology, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Robert W. Griebel
Affiliation:
Division of Neurosurgery, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
*
Division of Neurosurgery, Royal University Hospital, 103 Hospital Drive, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada S7N 0W8
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Abstract:

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Background:

Spinal epidural angiolipoma is a rare cause of spinal cord compression. We present a case and review the clinical presentation, radiological appearance, pathological aspects and treatment of this distinct clinico-pathological entity.

Methods:

A case of a 46-year-old woman with a five-month history of progressive myelopathy affecting her lower extremities is presented. CT and MRI revealed a large epidural fat-containing mass compressing the spinal cord dorsally at the T7-T8 level. A laminectomy was performed with gross total resection of the lesion.

Results:

The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has revealed no signs of tumor recurrence and no neurological deficit.

Conclusion:

The diagnosis of spinal angiolipoma should be considered in the differential diagnosis of spinal cord compression. Magnetic resonance imaging is the investigation of choice. The surgical objective is complete excision but, for anterior lesions involving bone, an overly aggressive approach should be tempered by an awareness of the overall indolent natural history of so-called "infiltrating" spinal angiolipomas that are only partially excised.

Résumé:

RÉSUMÉ:Introduction:

L'angiolipome épidural spinal est une cause rare de compression de la moelle épinière. Nous présentons un cas et nous revoyons la présentation clinique, les aspects radiologiques et anatomopathologiques ainsi que le traitement de cette entité clinico-pathologique distincte.

Méthodes:

Nous décrivons le cas d'une femme de 46 ans ayant une histoire de myélopathie progressive affectant ses membres inférieurs, évoluant depuis 5 mois. La tomodensitométrie et la résonance magnétique nucléaire ont montré une grosse masse épidurale contenant de la graisse et comprimant la moelle épinière au niveau de D7-D8. Une laminectomie a été effectuée avec exérèse de la lésion.

Résultats:

Les symptômes neurologiques de la patiente se sont améliorés après la chirurgie. Deux ans après, il n'y a aucun signe de récidive de la tumeur et pas de déficit neurologique.

Conclusion:

Le diagnostic d'angiolipome devrait faire partie du diagnostic différentiel dans la compression de la moelle épinière. L'imagerie par résonance magnétique est l'investigation de choix. L'objectif chirurgical est l'excision totale de la tumeur mais, quand il s'agit de lésions antérieures impliquant les structures osseuses, une approche agressive devrait être tempérée par la notion que les angiolipomes spinaux soit disant infiltrants ont une histoire naturelle plutôt indolente s'ils ne sont pas réséqués complètement.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 1 , February 2001 , pp. 82 - 88
Copyright
Copyright © The Canadian Journal of Neurological 2001

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