Lumbar spinal angiolipomas: report of two cases and review of the literature

Abstract

Study design: Case report and review of the literature. Objectives: To describe two patients with angiolipoma in the ventral aspect of the lumbar epidural space, to discuss the clinical, radiologic, and surgical features of these lesions, and to review previously reported cases. Setting: Rome, Italy. Methods: Two cases, a 60-year-old man and a 54-year-old woman presented with lumbarsciatic pain but with no abnormal neurological signs. Investigation (CT and MRI) demonstrated lumbar tumours. Results: Laminectomy and excision of the tumors were performed, and symptoms improved immediately. Conclusions: Magnetic resonance imaging with suppression fat sequences allows the recognition of these lesions. The prognosis after surgical removal of spinal angiolipoma is favorable.

Spinal extradural angiolipoma: report of two cases and review of the literature

“…Moreover, CT revealed tumor calcification in two patients [1,73], trabeculation of the vertebral body in two cases [90,93], erosion of the vertebral body and pedicle in another [1], a paravertebral thoracic component in two cases [1,90] and association with vertebral hemangioma in other [1] The tumor was hypo dense with the cord in 16 patients (between -20 to -72 HU), isodense in three patients [41,52,90], slight hyperdensity in three cases [63,74,77], and heterogeneous in only one case [1] where a reference to density was available. The epidural tumor did not show contrast enhancement in one case [41], demonstrated minimal contrast enhancement in two patients [52,93] and sharp contrast gain in three [57,63,76].…”

Lumbar spinal angiolipoma: case report and review of the literature

“…This form is most often seen in young adults, and multiple tumors are common. The ''infiltrating'' type of spinal angiolipoma is encapsulated and contains areas with a dominant vascular component [12]. The infiltrating form tends to arise in ventral locations within the thoracic and lumbar portion of the spinal column, and these lesions typically invade vertebral bodies and pedicles [2,7,13,15].…”

“…Lumbar spinal angiolipoma was first reported by Kasper and Cowan [3] in 1929. Since then, only 12 such cases have been documented [2,5,7,8,10,12,14,15]. In this paper, we present another case of lumbar spinal angiolipoma and discuss the relevant literature.…”

Lumbar Spinal Extradural Angiolipomas-Two Case Reports-

“…3) Only nine cases of angiolipomas involving the pure lumbar spine have been described (Table 1). 10,18,20,21,23,25) The thoracic predominance of spinal angiolipomas may depend on the regional variation in blood supply in the spine, and specifically that the mid-thoracic spine is the least wellperfused segment. 15) Most patients presented with a slow-growing mass causing compression of the spinal cord.…”

“…22,29) However, as in our cases, a few cases of angiolipoma situated in the lumbar extradural space have manifested as sciatica. 8,20,25) The more rapid onset of symptoms in some cases may depend on vascular factors, such as anomalous vessels, intralesional thrombosis, hemorrhage, or steal phenomena. 2,4,15,27) Symptom onset and exacerbation have also occurred during pregnancy, possibly in conjunction with an increase in tumor volume resulting in impaired spinal venous drainage, or hormonal changes resulting in an increase in extravascular fluid volume.…”