Spinal cord lipoma without dysraphism in the infancy that extends intracranially. Case report and review of the literature

Abstract

Background Spinal intramedullary lipoma extending to the posterior fossa is very rare in children. We made a revision of the literature and report the diverse opinions and surgical procedures. Case Description We report the case of a 16-month-old male infant who was operated on in the Pediatric Neurosurgical Unit of our hospital; his clinical and surgical outcome are related. Conclusion Intramedullary lipoma of the spinal cord with intracranial extension in infancy is a very rare pathology reported in the literature. Our patient was treated with decompression and subtotal removal; he had a critical postoperative course but was recovering slowly after that. Most authors prefer incomplete resection because these lesions do not have a clear-cut margin. Another neurosurgeon performed a decompression only, without resection. Some authors performed the surgical treatment before symptom progression. Another surgeon reported that the surgical indication is debatable when the neurologic manifestations are poor or absent. The surgical indication and the strategy for treatment are controversial and they depend on the clinical situations of the patients.