Abstract
Spinal intramedullary lipoma is rare accounting for 1% of all spinal tumours with usual location in the cervicothoracic region and usually associated with spinal dysraphism. These tumours usually have a slowly progressive indolent course. Our patient a 19 year young male presented with 2 months history of neck pain and acute onset rapidly progressive spastic quadriparesis with sensory level at T4. He did not have spinal dysgraphism. MRI spine revealed intramedullary lesions extending from cervicomedullary junction to upper dorsal cord which was hyperintense on T1 and T2 weighted images. Patient was subsequently operated and histopathology of the resected mass showed well circumscribed lesion composed of mature adipose tissue suggestive of lipoma.
Highlights
Spinal intramedullary lipoma is a rare lesion accounting for 1% of all spinal masses and 2% of intramedullary tumours [1]
Though CO2 laser and sonographic aspiration are known to reduce intraoperative damage to the cord and recommended prophylactic intervention in selected asymptomatic patients [4], treatment of intramedullary lipoma is controversial and surgical decompression is indicated for symptomatic lipomas [1]
Intramedullary lipomas are rare consisting of 2% of all intramedullary tumours and usually associated with spinal dysraphism [1]
Summary
Spinal intramedullary lipoma is a rare lesion accounting for 1% of all spinal masses and 2% of intramedullary tumours [1]. These lesions are commonly associated with spinal dysraphism [2]. Spinal intramedullary lipomas without spinal dysraphism are very rare and present in only 1% of patients [1,2]. Though CO2 laser and sonographic aspiration are known to reduce intraoperative damage to the cord and recommended prophylactic intervention in selected asymptomatic patients [4], treatment of intramedullary lipoma is controversial and surgical decompression is indicated for symptomatic lipomas [1]. Surgical intervention in symptomatic patients may lead to significant residual disability [4]
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