Spinal epidural angiolipoma: A rare cause of spinal cord compression

Abstract

Spinal epidural angiolipomas are rare, benign tumors composed of mature lipocytes admixed with abnormal blood vessels. Only 128 cases of spinal epidural angiolipomas have been reported in literature till now. Spinal angiolipomas are predominantly located in the mid-thoracic region. We report a case of dorsal epidural angiolipoma in a 56-year-old male who presented with paraparesis and was diagnosed to have D4-5 epidural angiolipoma. Total surgical excision of the epidural angiolipoma was done and his paraparesis gradually improved.

Intraarticular Giant Size Angiolipoma of the Knee Causing Lateral Patellar Dislocation

“…The subcutaneous region of the trunk, neck and extremities are the places where they generally settle. They may be visible in any part of the body (2). The most frequent settling place is particularly the forearm; almost two third of the angiolipomas are seen here (3).…”

Hemorrhagic onset of spinal angiolipoma

“…Magnetic resonance imaging is the modality of choice when diagnosing spinal angiolipoma. [4][5][6] On MRI, angiolipomas are iso-or hyperintense on T1-weighted images and variable on T2-weighted images but usually hyperintense. The degree of central hypointensity on T1-weighted images is predictive of the degree of vascularity; 5,13 therefore, heterogeneous hyperintensity lesions with focal hypointensity on T2-weighted images should suggest a diagnosis of acute/ hyperacute spinal epidural hematoma.…”

“…Noninfiltrating angiolipomas are well defined and separate from the surrounding tissue and can usually be easily removed via laminectomy and dissecting techniques. Infiltrating spinal angiolipomas ideally require a wider resection; 4,5 however, even cases of subtotal resection of the infiltrating variant reportedly have good outcomes 17 in terms of spinal cord decompression. One case of preoperative embolization of an infiltrating angiolipoma has been previously described, and the authors reported that this maneuver allowed complete removal with minimal intraoperative blood loss.…”

“…1 Many factors contribute to the accelerated onset of symptoms, including rapid expansion of tumor volume caused by enlarging or degenerating blood vessels or hemorrhage within the lesion, as well as venous stasis with thrombosis, vascular steal, and pregnancy, which likely aggravate symptoms because of impaired spinal venous drainage or hormonal changes. 1,5,12,16 The etiology of spinal angiolipoma is unknown. These tumors might result from the abnormal development of primitive pluripotent mesenchymal cells, as postulated by Ehni and Love.…”

“…5 This case represents the second reported instance of the hemorrhagic onset of spinal angiolipoma. 1 …”