Fatty syringomyelia mimicking lipoma with spinal cord pilocytic astrocytoma

Abstract

The reporting case is a 27 year-old woman. She was admitted with complaints of clumsy gait and dysesthesia over her upper limbs and spasticity in the legs. The investigations revealed a long segment cervical intramedullary tumor, associated with whole cord syringomyelia. The superior part of syringomyelia image intensity matched intramedullary lipoma completely. C1–C5 intramedullary tumor was resected grossly under microscopic view, and a fat-containing liquid exited the syringomyelia cavity at its superior pole. After a transient paresis just following the surgery, neurological condition was improved. The follow-up imaging showed that the fatty syringomyelia reduced in dimensions. Conclusion. According to this case and another similar case due to instability, it appears that as a rare phenomenon, syringomyelia liquid content sometimes could have fatty droplets which could mimic intramedullary lipoma with an unknown mechanism. It seems these fat droplets in syringomyelia would not change its natural history.

Intramedullary lipoma mimicking syringomyelia: A case report and literature review

“…There have been reported syringomyelia cases mimicking intramedullary lipoma 7,8 and an intramedullary lipoma case combined with syringomyelia 9 (Table 1). In patients with intramedullary tumors, syringomyelia can occur either above or below the tumor.…”

“…There were two cases reporting that the syringomyelia contained fat droplets, which was named fatty syringomyelia. 7,8 According to Goel and colleagues, excess fluid, fat tissue, and even bone tissue in the spinal cord may be associated with spinal cord instability, which represents the body's self-protective mechanism for the spinal cord. 7 The fatty syringomyelia and lipoma were alike in MRI appearance.…”