Management of infiltrating spinal epidural angiolipoma

Abstract

Angiolipomas of the spine are rare benign tumors commonly presenting with compressive myelopathy. The present report describes a case of spinal angiolipoma with thoracic mediastinal extension in a 50-year-old woman. She presented with a long-standing history of mid-back pain with progressive lower extremities weakness. An MRI showed a heterogeneously enhancing mass located in the posterior epidural space of the thoracic spine with mediastinal extension. Histopathological examination demonstrated features consistent with spinal angiolipoma. This report emphasizes the diagnosis and therapeutic management options of infiltrating spinal angiolipomas.

Epidural angiolipoma with concomitant intradural extramedullary capillary hemangioma at the same spinal level: A case report

“…Gross-total resection via laminectomy and durotomy is the primary treatment option for SALs and SIECHs (2,4,6,16). Total removal of infiltrating SALs is impossible in certain cases; however prognosis seems not to differ significantly from completely resected non-infiltrating tumors (20). Angiography and preoperative embolization may be used to diagnose and treat some SALs and SIECHs (20,21).…”

“…Total removal of infiltrating SALs is impossible in certain cases; however prognosis seems not to differ significantly from completely resected non-infiltrating tumors (20). Angiography and preoperative embolization may be used to diagnose and treat some SALs and SIECHs (20,21). The prognosis of both tumors is good; only a few cases of recurrence have been reported (9,21,22).…”

Angiolipoma on the Lumbar Spine

“…Total surgical resection is the treatment of choice, but total removal of the mass is difficult in cases of infiltrating angiolipomas. Noninfiltrating angiolipomas have a good prognosis after total surgical resection, and infiltrating angiolipomas have a good prognosis after incomplete resection 6 , 12) . Previously, wider resection including the surrounding tissue was recommended for infiltrating angiolipomas 11) .…”

“…Most spinal angiolipomas have a good prognosis following surgical resection, and noninfiltrating tumors are relatively easily dissected from the dura and adjacent structures because of the good encapsulation of the mass 1 , 10) . In contrast, infiltrating tumors are entirely or partially unencapsulated 12) .…”

Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature

“…Spinal angiolipomas comprises 0.04%-1.2% of all spinal cord tumors and spinal 2-3% of extradural tumors [ 2 , 4 - 7 ]. Most of spinal angiolipomas are seen in thoracic region of posterior extradural areas [ 5 , 8 ]. Lumbar spinal angiolipomas are rarely seen and comprise 9.6% of all spinal angiolipomas [ 5 , 9 , 10 ].…”