Spinal epidural angiolipomas: Clinical characteristics, management and outcomes

Abstract

Purpose:The spinal epidural angiolipomas are rare expansive processes made of mature lipomatous and angiomatous elements. They often have a benign character. Their etiology, pathogenesis remains uncertain, and it is a cause of spinal cord compression. The magnetic resonance imaging is the most important neuroradiological examination. Histological examination is the only examination to confirm the diagnosis. Surgery is the treatment of choice.Methods:A retrospective study of all patients operated on for a spinal epidural angiolipoma at the Department of Neurosurgery at the National Institute of Neurology of Tunis between January 2000 and December 2014 (15 years) was performed. The aim of this study is to describe the clinical, radiological, histological characteristics and the treatment of this tumor.Results:A total of nine patients were operated from January 01, 2000 to November 30, 2014. The average age of our patients was 51 years with ages that ranged from 29 to 65 with a male predominance. The period between onset of symptoms and diagnosis ranged from 24 months with an average 12 months. Posterior localization of the tumor was seen in all patients. Surgical resection was performed for all cases. The postoperative course has been satisfactory, with a complete recovery of neurological functions in all patients.Conclusions:The spinal epidural angiolipomas is rare expansive process causing spinal cord compression. Treatment is exclusively surgical resection. The functional outcome of spinal epidural angiolipomas is particularly favorable with a complete neurological recovery is if the patient was quickly operated.

Epidural angiolipoma with concomitant intradural extramedullary capillary hemangioma at the same spinal level: A case report

“…SALs are categorized into two types: The majority are 'non-infiltrating' and the minority are 'infiltrating', according to whether they involve the vertebra or surrounding tissues (14). The infiltrating type is of either intramedullary or intervertebral occurrence (15). Notably, because 23.8% cases of SALs coexist with vertebral hemangioma (2,12) and the pathology and imaging features of spinal infiltrating angiolipomas with bone involvement are similar to those of aggressive vertebral hemangiomas, it has been questioned whether they represent two distinct entities (6).…”

“…MRI is considered to be the most accurate method of investigating SALs and SIECHs. This is primarily because radiographs and computed tomography (CT) can only detect an erosion of pedicles, vertebral body or trabeculation, which are indirect and general signs of intraspinal space-occupying tumors (12,15). Most SALs exhibit hyperintensity on T1WI while the hypointense region on the non-contrast T1WI appears to be of vascular origin, revealing a notable enhancement following gadolinium administration (17).…”

Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature

“…The first spinal angiolipoma case was reported in 1890 by Berenbruch [ 3 , 28 ]. Howard and Helwig defined angiolipoma as a clinicopathologic entity including vascular and mature adipose elements in 1960 [ 2 , 4 ].…”

“…Besides, they locate in the body and arm [ 1 ]. Angiolipoma is rarely seen in the spinal canal [ 2 , 3 ].…”

“…Spinal angiolipoma is a rare specific clinicopathologic entity, which is to be distinguished from skin angiolipoma [ 3 ]. Spinal angiolipomas comprises 0.04%-1.2% of all spinal cord tumors and spinal 2-3% of extradural tumors [ 2 , 4 - 7 ]. Most of spinal angiolipomas are seen in thoracic region of posterior extradural areas [ 5 , 8 ].…”