Lipomas of the spinal cord and cauda equina.

Abstract

✓ This report presents 18 cases of lipoma of the spinal cord or cauda equina, four of which were unassociated with congenital anomalies of the spine and 14 with such anomalies. Review of the literature shows that unassociated cases are rare, with only 100 cases reported, while those associated with congenital anomalies are more common. The patients ranged in age from 2 months to 5 years. Fourteen patients had external evidence of an abnormality in the form of a mass or dimple over the vertebral column. Plain x-ray films showed evidence of an intraspinal lesion in all cases except one. The treatment was surgical in all cases, with nine good results, eight satisfactory, and one unsatisfactory. The exact pathogenesis of spinal cord lipomas is unclear, although the high incidence of associated congenital defects, age of onset, and location of the tumors suggest a developmental origin. The tumors occupy a juxtamedullary-subpial location and are composed of firm, lobulated adult fat. Early surgery consisting of generous laminectomy, incision of the pia, and subtotal removal of the tumor is felt to be the treatment of choice.