A case report and review of thoracic spinal angiolipoma

Abstract

Background:While it is a rare entity, spinal angiolipomas are well-defined benign tumors that have been described sporadically in the literature starting from the late 1800s. Composed of mature lipomatous and angiomatous elements, these tumors manifest neurological symptoms due to progressive spinal cord or root compression. We present a case of a thoracic spinal angiolipoma and review the relevant literature.Case Description:A 68-year-old male with ongoing bilateral lower extremity weakness was found on enhanced magnetic resonance imaging to have an extradural mass in the thoracic spine causing cord compression. A T4–T8 laminectomy and complete excision of the epidural mass resulted in reversal of the patient's neurological symptoms. Histopathology identified the mass as a thoracic spinal angiolipoma.Conclusion:Given its uncommon occurrence and excellent prognosis, our report serves as a reminder to always consider spinal angiolipoma in the differential diagnosis of epidural masses.

Thoracic Spinal Angiolipoma: A Case Report and Literature Review

“…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) .…”

“…Spinal angiolipoma (SAL) occurs in approximately 0.04% to 1.2% of all spinal tumors 17,23,28,30,32,37) . SAL is a benign tumor made up of adipose tissues and vasculature 1,16,22,23,[27][28][29][30]32,34,35,38,39,42) . Although the tumor is usually found within the thoracic epidural space, SAL is sometimes found within the lumbar epidural space.…”

“…The main treatment in SAL cases is surgical removal. Even when infiltrating type is subtotally removed, the prognosis is good 18,27,33,39,40) . We report a case of a patient with SAL complaining of cord compression symptoms arising from the thoracic level.…”

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

“…7,23 The clinical signs and symptoms of SALs are similar to those of spinal cord or nerve root compression, although the severity varies according to the lesion location and proliferation rate. Idiosyncratic complaints are typically sensory disorders and motor deficits below the level of the lesion, and these symptoms usually progress over the course of months, 24,25 ultimately leading to weakness in the lower limbs in the later stages. The diagnosis always takes more than 1 year.…”

Lumbar Extradural Angiolipoma: Clinical Presentation and Management

“…Isolated extradural primary tumors arising in the epidural canal are rare. Spinal angiolipomas are very rare tumors and less than 200 cases have been described in the literature [ 4 ].…”