Abstract
Most of the spinal cord lipomas reported in the literature are intradural extramedullary, and true intramedullary lipomas are very rare. We present a case of intramedullary spinal cord lipoma of the cervico-thoracic region with extensions over many spinal segments. Magnetic resonance (MR) examination showed an intramedullary lipoma of the cervico-thoracic spinal cord of both high T1 and T2-weighted signal intensity and suppression on fat saturation sequence. MR imaging assessment is critical in the detection of intramedullary lipomas which may present without any neurological deficit at an early stage. Early diagnosis may lead to prevention of the irreversible deterioration of neurological functions.
Highlights
Most of the spinal cord lipomas reported in the literature are intradural extramedullary, and true intramedullary lipomas are very rare
We present a patient who has an intramedullary lipoma of the cervico-thoracic spinal cord in the absence of any spinal anomaly
Lipomas of the spinal cord in the absence of spinal dysraphism are rare and account for less than 1% of all spinal tumours
Summary
A A 32-year-old man presented for assessment of a 2 year- history of right arm and neck pain. There was no enhancement and signal intensity was diminished with fat saturation techniques (Fig. 1D, H) These MR imaging findings were typical for lipoma. The spinal MR imaging revealed an intradural tumor of the cauda equina, in lumbar region which had cystic components and fat containing solid components, consistent with a dermoid cyst (Fig. 1E, F, H). — (D) Postcontrast fat-suppressed T1-weighted sagittal cervicothoracal image shows reduced signal intensity from the lesion. This sequence demonstrates the tissue to be composed of fat. In view of lack of neurological deficits, neurosurgeons prescribed clinical and MR imaging follow-up for this patient
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