Nondysraphic intramedullary spinal cord lipomas: a review

Bhatoe, Harjinder S; Singh, Prakash; Chaturvedi, Aarti; Sahai, Kavita; Dutta, Vibha; Sahoo, Prakash Kumar

doi:10.3171/foc.2005.18.2.10

Cited by 54 publications

(79 citation statements)

References 10 publications

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“…Intraspinal lipomas account for 1% of all spinal cord tumors, and up to 99% of them are associated with spinal dysraphism (12). Intraspinal lipomas can be divided into 3 main types: lipomyelomeningoceles (or lipoma of the conus medullaris), intradural lipomas, and fibrolipomas of the filum terminale.…”

Section: Types Of Tumorsmentioning

confidence: 99%

Pediatric Spinal Cord Tumors and Masses

Wilson

Oleszek

Clayton

2007

The Journal of Spinal Cord Medicine

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Background/Objective: Spinal cord tumors are a relatively rare diagnosis, accounting for 1% to 10% of all pediatric central nervous system tumors. Understanding the etiology and clinical outcomes of these tumors is therefore very important. This study presents detailed information regarding clinical presentation, histological findings, outcomes, functional assessment, and management of a series of patients with this diagnosis.Method: Retrospective, descriptive study.Subjects: Thirty-five children with a final diagnosis of spinal cord tumor or mass, excluding dysraphism.Results: Neurodevelopmental tumors (dermoid tumors, epidermoid tumors, and teratomas) were the most common tumor type (31%), followed by astrocytomas (29%) and neuroblastomas (14%). Other types included schwannomas, meningiomas, giant cell tumors, extradural cystic masses, leukemic-related masses, and masses related to neurofibromatosis. Mean age at diagnosis was 6.6 years (SD ¼ 5.5 y) and did not vary significantly by tumor type except for children with neuroblastoma (mean ¼ 0.4 y, SD ¼ 0.5 y). More boys (57%) were identified in the series than girls (43%); however, there was no association between tumor type and sex. Presenting complaints of pain were noted in 57% and were localized to the back, neck, or extremities. Extremity weakness was reported as an initial presenting symptom in 46%. Three children had scoliosis as a presenting issue and 14 had gait abnormalities. Regardless of treatment modality, mobility was retained in 83% of children with or without gait aids. Neurogenic bowel and/or bladder were present in 23% of the population.Conclusions: This study corroborates other studies indicating that intramedullary tumors are the predominant form of pediatric spinal cord tumor. This population, however, presented with an unusually large number of developmental tumors, contrary to several published studies. The disparity may be the result of this institution acting as a regional referral center, thus increasing the number of this type of patient. The population is too small to make any other conjecture. The predominance of astrocytomas and neuroblastomas among those patients with poor outcomes and the prevalence of developmental tumors suggest the need for broader investigation. Although, in general, spinal cord tumors are relatively rare, this preliminary study supports the need to further evaluate associations between tumor type, presenting symptoms, treatment, and functional outcome in children with spinal cord tumors.J Spinal Cord Med. 2007;30:S15-S20

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Section: Types Of Tumorsmentioning

confidence: 99%

Pediatric Spinal Cord Tumors and Masses

Wilson

Oleszek

Clayton

2007

The Journal of Spinal Cord Medicine

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“…They occur in males and females with equal frequency [1]. During the first year of life, these lesions may present with tetraplegia or floppy infant syndrome [2,3]. Young children/infants can also present with retarded motor development as happened in the present case.…”

Section: Discussionmentioning

confidence: 68%

Successful Surgical Excision of a Nondysraphic Holodorsal Intramedullary Lipoma in a 14-Month-Old Child

Kumar¹,

Chandra²,

Bisht³

et al. 2011

Pediatr Neurosurg

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Introduction: Nondysraphic intramedullary lipomas of the spinal cord are rare lesions. They are most commonly seen in the second or third decade of life. Their occurrence in the pediatric age group is even rarer. Case Report: The authors describe a 14-month-old child who presented with delayed motor milestones involving the bilateral lower limbs. The child was unable to sit or stand. MRI revealed a dorsally located intramedullary lipoma extending from C₇ to D₁₂. The child underwent C₇–L₁ laminotomy and gross total excision of the lipoma. Postoperatively, the child improved neurologically and attained normal power in the bilateral lower limbs. Discussion: Very few cases of extensive intramedullary lipomas involving the dorsal cord have previously been reported. Only two cases of pediatric extensive dorsal lipomas have been mentioned to date. The authors describe successful surgical excision of a holodorsal intramedullary lipoma in a 14-month-old child. To the best of the authors’ knowledge, this is the first case being reported of a holodorsal intramedullary lipoma in the youngest patient.

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“…A chance of recurrence of lipoma does exist. The difficulty in surgical treatment arises because these lesions do not often have clear-cut margins, making it hard to perform an exact excision while avoiding damage to the surrounding spinal cord structures 14. For more apparent reasons, it is vital to preserve neurological function, even if this means incomplete resection at the time of surgery as described above in our case.…”

Section: Discussionmentioning

confidence: 90%

Recurrent 'universal tumour' of the spinal cord

O’Grady

Kaliaperumal²,

O’Sullivan³

2012

Case Reports

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SummaryLipoma is popularly known as the 'universal tumour' because of its ubiquitous presence anywhere in the body. This is the first documented case of recurrent thoracic spinal cord intramedullary lipoma in a 44-year-old man, with a background of spinal dysraphism, which recurred 15 years after initial surgery. He was followed up every 2 years and currently presented with an 8-month history of progressive weakness in his lower limbs. An MRI of the spine confirmed recurrence of lipoma. He underwent redo laminectomy and partial resection and spinal cord decompression with duroplasty. Lipoma, although a low-grade tumour, can cause significant neurological deficits because of its location. Surgical exploration and removal of lipoma is recommended. However, to preserve the functionality of the spinal cord, one may resort to partial resection and aim for spinal cord decompression. The literature on spinal cord lipoma is reviewed and the aetiopathogenesis of this rare occurrence is described. BACKGROUND

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Nondysraphic intramedullary spinal cord lipomas: a review

Cited by 54 publications

References 10 publications

Pediatric Spinal Cord Tumors and Masses

Pediatric Spinal Cord Tumors and Masses

Successful Surgical Excision of a Nondysraphic Holodorsal Intramedullary Lipoma in a 14-Month-Old Child

Recurrent 'universal tumour' of the spinal cord

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