Intramedullary spinal cord lipoma mimicking a late subacute hematoma

Abstract

Spinal cord lipomas are rare and benign tumors which may cause progressive neurological deficits due to their local expansion. We present the case of a 59-year-old male patient with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images of the thoracic spine suggested a subacute intramedullary hematoma. Due to progression of the neurological deficit, the patient was referred to a neurosurgeon, who indicated surgical evacuation of the hematoma. The intraoperative finding revealed an intramedullary spinal cord lipoma, which was later confirmed by histological analysis. Since subacute intramedullary hematomas and intramedullary spinal cord lipomas present with similar clinical and radiological features, diffusion-weighted MR imaging should be used to distinguish these entities.

Imaging spectrum of spinal dysraphism: A diagnostic challenge

“…Intradural lipoma : Adipose cells inside the dural sac constitute this benign lesion. 10 , 11 The embryologic mechanism is similar to that of the lipomyelocoele. A subpial lipomatous lesion is seen on MRI lying between the fibres of the placode.…”

Adult cervicothoracic subpial fibrolipoma without dysraphism: An extremely rare case report

“…However, when their symptoms appear, they often worsen swiftly and cause serious neurological damage. An intramedullary spinal cord lipoma mimics a late subacute hematoma [ 10 ].…”

Nondysraphic Intradural Spinal Lipoma: A Rare Case in a Child

“…Most are intradural (60%), while the rest are extradural (40%). The clinical presentation and its neurological component are quite variable depending on the size and location of the lesion, but it usually evolves insidiously [2]. The case in question presented early symptoms with motor delay due to the significant tumor volume [3].…”