Spinal extradural angiolipomas: A case report

Abstract

Angiolipoma are benign tumors composed of mature adipocytes ad mixed with abnormal vascular elements. It reportedly accounts for 0.1–0.5% of all spinal axis tumors in adults and is extremely rare in children. This article describes a case of spinal extradural angiolipoma in a 35-year-old man, who presented with paraplegia and sphincter disorders, the MRI showed extradural spinal lesions at the level of T7 to T10, that squeezed the spinal cord. We attained total resection without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may imitate other spinal lesions. The gold standard treatment modality should always be surgery, however in some cases, total resection can not be done.

Thoracic Spinal Angiolipoma: A Case Report and Literature Review

“…According to Josephs et al 17) , several factors related to the growth of SAL are trauma, weight gain, and hormones 30) . Obesity and pregnancy can promote SAL growth bystimulating hormones that affect the growth of adipose tissue 4,9,23,25,28,31,38) .…”

“…Differential diagnoses of SAL include arteriovenous malformations, nerve sheath tumors, meningioma, metastasis, chronic extradural hematoma, and lymphoma 4,12,24,25,29) . Among them, the growth patterns of spinal epidural meningiomas are commonly the en plaque, dumbbell or fusiform type 24,44) .…”

“…MRI is the most valuable tool for diagnosing SAL before surgery 1,4,19,23,27,38,46) . Though tumors display variable intensity across T1 and T2, they are usually hyperintense in both T1 and T2-, and homogenously enhanced in T1 images 1,8,18,29,30,38,39) .…”

“…It is also found within the cervical and sacral epidural space, though rarely 9,18,32,35,38) . Usually, SAL grows slowly and compresses the spinal cord or root, causing symptoms gradually 4,12,18,31,40,46) . SAL can be subdivided into two types, non-infiltrating and infiltrating 1,18,23,32,33,35,40) .…”

“…In contrast, the infiltrating type is not encapsulated, making total removal difficult 1,23,33,39,42) . Magnetic resonance imaging (MRI) has an important role in diagnosing SAL, but the gold standard for diagnosis is pathological diagnosis 1,4,18,23,32,38) . The main treatment in SAL cases is surgical removal.…”