Thoracic spinal epidural angiolipoma: report of two cases and review of the literature

Abstract

AIm: Spinal angiolipoma is a benign uncommon neoplasm composed of mature lipocytes admixed with abnormal blood vessels, and accounts for only 0.14-1.2% of all spinal tumors. mAteRIAl and methods: Retrospective data analysis. Results:We report two cases of a 64-year-old woman and a 65-year-old man with thoracic myelopathy due to spinal angiolipoma. Magnetic resonance imaging showed isointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging and enhance with gadolinium administration. In one case, angiography elucidated the vascularity of the tumor and the relationship with concomitant hemangioma. Laminoplasty was performed to achieve tumor resection, and the postoperative course was uneventful with neurological improvement. Histopathological examination of the resected tumors revealed angiolipomas.ConClusIon: Although extremely rare, thoracic spinal epidural angiolipoma should be considered in the differential diagnosis of thoracic spinal lesions. Prognosis after surgical management of this lesion is favorable. Angiography was useful for preoperative evaluation of vascularity and the relationship with concomitant tumors. KeywoRds: Spinal epidural tumors, Angiolipoma, Myelopathy, Angiography ÖZAmAÇ: Spinal anjiyolipom nadir bir benign neoplazm olup anormal kan damarlarıyla karışmış matür lipositlerden oluşmuştur ve tüm spinal tümörlerin sadece %0,14 -1,2'sini oluşturur. yÖntem ve GeReÇleR: Retrospektif veri analiziBulGulAR: Spinal anjiyolipom nedeniyle torasik myelopatisi olan 64 yaşında bir kadın ve 65 yaşında bir erkek şeklinde iki vaka bildiriyoruz. Manyetik rezonans görüntüleme T1 ağırlıklı görüntülemede izointensite ve T2 ağırlıklı görüntülemede hiperintensite gösterdi ve gadolinyum uygulamasıyla güçleniyordu. Bir vakada anjiyografi tümörün vaskülaritesini ve eş zamanlı hemanjiyomla ilişkisini gösterdi. Tümör rezeksiyonu için laminoplasti yapıldı ve postoperatif seyir nörolojik düzelmeyle birlikte olaysız geçti. Rezeksiyonu yapılmış tümörlerin histopatolojik incelemesi anjiyolipom gösterdi. sonuÇ: Çok nadir olsa da torasik spinal epidural anjiyolipom torasik spinal lezyonların ayırıcı tanısında dikkate alınmalıdır. Bu lezyonun cerrahi tedavisinden sonra prognoz olumludur. Vaskülaritenin ve eş zamanlı tümörlerle ilişkinin değerlendirilmesi için anjiyografi faydalı olmuştur.

Acute paraplegia by spinal angiolipoma. Case report and literature review

“…3,8 Subsequently, angiolipomas were subdivided into two categories by Lin et al 9 non-infiltrating and infiltrating. The non-infiltrating type is encapsulated and well delimited, without invasion of the dura mater of the vertebrae.…”

“…Infiltrating spinal angiolipomas are found in the anterior epidural space, and can invade the vertebral body. 3,4,9 Histologically, the lesion is mostly made up of mature adipose cells and blood vessels. The fat composition is similar to that of adipose tissue, and the vascular components generally consist of capillaries, thin-walled or thick-walled sinusoids with smooth muscle, and occasionally, small well-developed arteries.…”

“…mixoid changes, hyalinization, and fibrosis) may be present in some cases with long evolution. 3 Clinical presentation They occur mostly in women (women: men = 22:17) and most often during the 4th and 5th decades of life. The form of presentation can be acute, subacute, or chronic and may include progressive, remittent, or recurrent radicular and paraplegic signs and symptoms.…”

“…[1][2][3] Location in the lumbar spine is not very common. 1,4 It generally follows a slow and progressive clinical course, and acute myelopathy is very rare.…”

“…6 There are only 142 cases of extradural spinal angiolipoma reported to date. 3 They account for between 0.14% and 1.2% of all tumors of the spinal cord and 2% to 3% of epidural spinal tumors. They can be classified into two subtypes: non-infiltrating and infiltrating.…”