Intradural-Extramedullary Cervical Cord Lipoma: Case Report and Literature Review.

Abstract

Spinal lipomas are generally thought to occur as a result of failed primary neurulation. Failed primary neurulation allows invasion of mesenchymal tissue of mesodermic origin into the neural structure, leading to the formation of a spinal lipoma. Despite most spinal lipomas being regarded as the result of failed primary neurulation, some confusion in terms of the embryogenesis of spinal lipomas remains. Recently, a novel classification of spinal lipomas based on embryonic changes seen during primary and secondary neurulation was has been proposed. We present a case of an intradural-extramedullary spinal cord lipoma, associated with a subjacent subcutaneous lipoma at the cervicothoracic region. The patient presented with worsening neurologic symptoms, indicating ongoing cervical myelopathy. A subtotal resection along with posterior cervical stabilization was achieved, with mild improvement of neurologic symptoms. Clinical, pathologic, and radiologic records are reviewed. To the best of our knowledge, this is the first described case of a spinal cord lipoma with at such a location, one that cannot be fully categorized within the newly proposed classification system.