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Purpose:The spinal epidural angiolipomas are rare expansive processes made of mature lipomatous and angiomatous elements. They often have a benign character. Their etiology, pathogenesis remains uncertain, and it is a cause of spinal cord compression. The magnetic resonance imaging is the most important neuroradiological examination. Histological examination is the only examination to confirm the diagnosis. Surgery is the treatment of choice.Methods:A retrospective study of all patients operated on for a spinal epidural angiolipoma at the Department of Neurosurgery at the National Institute of Neurology of Tunis between January 2000 and December 2014 (15 years) was performed. The aim of this study is to describe the clinical, radiological, histological characteristics and the treatment of this tumor.Results:A total of nine patients were operated from January 01, 2000 to November 30, 2014. The average age of our patients was 51 years with ages that ranged from 29 to 65 with a male predominance. The period between onset of symptoms and diagnosis ranged from 24 months with an average 12 months. Posterior localization of the tumor was seen in all patients. Surgical resection was performed for all cases. The postoperative course has been satisfactory, with a complete recovery of neurological functions in all patients.Conclusions:The spinal epidural angiolipomas is rare expansive process causing spinal cord compression. Treatment is exclusively surgical resection. The functional outcome of spinal epidural angiolipomas is particularly favorable with a complete neurological recovery is if the patient was quickly operated.

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ABSTRACTedema and no contrast enhancement were noted. There was a mass effect in the form of effacement of the left occipital horn and moderate midline shift (Figure 1). On MRI study, the lesion appeared to be extra-axial and getting in touch with an osteoma. Mass, measuring 55 x 40 x 52 mm, displayed high signal intensity on T2 weighted images and a low signal intensity on T1 weighted images (Figure 2A-C). There were many peripheral low signal abnormalities on flash 2d images suggesting calcifications (Figure 3). T1 weighted images with gadolinium showed peripheral enhancement. There was no surrounding edema. Radiologically, the mass does not resemble a special tumor and it was difficult to advocate a preoperative diagnosis (Figure 4). at surgery, a left temporoparietal craniotomy was done. We first noted the osteoma at the inner surface of the bone that erodes the dura. The tumour was extra-axial, well circumscribed, pearly white in colour, soft in consistency and avascular. It was completely removed. The tumor capsule was also separated from normal brain and excised. The presence of hair and pultaceous material within the tumor could make the surgical diagnosis of a dermoid tumor and this was confirmed by histological studies. The patient postoperative █ InTRODuCTIOnDermoid cysts are benign dysembryogenic tumors originating from ectopic inclusions of epithelial cells during closure of neural tube. They account for about 0.04 to 0.7% of all intracranial tumors (20) with a predilection in the cranial midline, the parasellar and sylvian cisterns (2, 9, 27). Commonly dermoid cysts have characteristic computed tomography (CT) and magnetic resonance imaging (MRI) features making their preoperative diagnosis straightforward although this was not possible in our case.█ CASE REPORT a 48-year-old female, with no past medical history, was referred to our department with complaints of headache, vomiting and visual disturbances that started six months prior to admission.On presentation, the patient was having no neurological deficit. Her general physical and systemic examinations were also normal. A CT of the brain showed a heterogeneous isohypodense left temporo-parietal lesion with an osteoma in front of it and some peripheral calcifications. No surrounding Intracranial dermoid cysts are benign, slow growing tumors derived from ectopic inclusions of epithelial cells during closure of neural tube. These lesions, accounting for less than 1% of intracranial tumors, have characteristic computed tomography (CT) and magnetic resonance imaging (MRI) appearances that generally permits preoperative diagnosis. However, the radiologic features are uncommon and the cyst can be easily misdiagnosed with other tumors in rare cases. Herein, we report a case of a left temporoparietal dermoid cyst in a 48-year-old woman that was peroperatively and histopathologically proven but not advocated on CT and MRI. Clinical, radiological and histopathological features of a dermoid cyst are reviewed.