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

Abstract

Spinal extradural angiolipomas (SEALs) are extremely extraordinary benign extradural lesions. They are infrequently encountered in normal clinical practice although several authors have report single cases or case series. We present two cases of SEAL which we successfully surgical resected with no further neurological deficits. Our cases comprise of a male and a female with ages ranging from 30 to 60 years. Their principal presenting complains were numbness and pain at the lower extremity with associated fecal and urinary incontinence. In all our cases, MRI revealed extradural spinal lesions that exerted compressive effect on the spinal cord. The male patient had an infiltrating type while the female had non-infiltrating type. We attained total resection in both cases without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may mimic other spinal lesions. The gold standard treatment modality should always be surgery although total resection may not be achievable in some cases.

Acute Onset Paraplegia Due to Thoracic Angiolipoma: A Case Report and Review of the Literature

“…Hormonal imbalance, pregnancy and weight gain have been shown to be risk factors for the development of acute neurological findings in SAL [5]. Surgical treatment has good outcomes regardless of preoperative neurological finding even in subtotal resection [6,7]. In our case we report presentation of acute onset paraplegia with previous back pain and weight gain history.…”

A rare case report of sacral epidural angiolipoma: Diagnosis and treatment

“…Surgical resection of the lesion through anterior approach or posterior laminectomy is the gold standard treatment modality. [ 13 ] We used posterior approach to access the tumor in our case and we attained total tumor resection.…”

Spinal epidural angiolipoma causing spinal cord compression

“…Some studies suggest that it represent 0.04% to 1.2% of spinal tumours, 2% to 3% of epidural spinal tumors (1,3,5,6,8) and 16 % to 35 % of spinal lipomas (5,8). It has a female predominance (1,2,3,4,5,7,8) with a sex ratio of 3/2 (8), with an average age between 40 and 60 years(2,3,4,7) and mostly located in thoracic spine (1,2,3,4,5,6,7,8) in 78 % of cases (8), mostly between Th2 and Th5 (6), other location are less common, it occurs in 10 % in the lumbar spine and in 1 % in the cervical spine (8).SAL can be infiltrating or non-infiltrating, In the majority of cases it is non infiltrating encapsulated and limited in the epidural space (3,7,8).The clinical presentation include back pain and signs of spinal cord compression (1,2,3,4,5,6,7,8), although the symptoms evolves slowly some cases of acute paraplegia were described (4).MRI is the imaging of choice for SAL diagnosis (1,2,3,4,5,6,7,8) ,commonly the tumour has a fusiform shape located in the posterior epidural space (2,4,5), the signal of the lesion is the reflect of its two components: lipomatose and angiomatose, so SAL is usually hyperintense in T1 and T2 weighted images with loss of the signal in fat suppression sequences which could be regained after injection of gadolinium (1,2,3,6,8).Surgery is the reasonable treatment modality (1,2,3,4,6,<...>…”