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Non-dysraphic intradural spinal cord lipoma: case series, literature review and guidelines for management

  • Clinical Article
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Acta Neurochirurgica Aims and scope

Abstract

Purpose

Non-dysraphic intradural spinal cord lipomas are rare lesions and the management remains controversial. We present our experience with five cases and propose guidelines for their management.

Methods

Five patients who underwent surgery for non-dysraphic spinal cord lipomas between January 2004 and April 2009 were retrospectively reviewed. All had varying degrees of neurological symptoms at the time of surgery with characteristic features on magnetic resonance imaging (MRI). All patients underwent decompression with a laminectomy/laminoplasty and debulking. The dura was primarily closed in one patient. The literature was also extensively reviewed regarding these rare lesions and optimum management guidelines proposed.

Results

The age at presentation ranged from 17 to 52 years (mean 32.2). Minimum follow-up was 8 months and maximum follow-up was 5 years. There was neurological improvement following surgery in all cases. Post-operative MRI scan showed evidence of significant residual tumour in all patients.

Conclusion

The extent of surgical resection does not necessarily correlate with clinical outcome. The aim of surgery should, therefore, be adequate decompression with preservation of neural structures. Aggressive debulking should be avoided. Onset of any neurological symptoms/signs, bowel or bladder symptoms or intractable local symptoms should be an indication for surgery.

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References

  1. Akyuz M, Goksu E, Tuncer R (2005) Spontaneous decrease in the size of a residual thoracic intradural lipoma. Br J Neurosurg 19:53–55

    Article  PubMed  Google Scholar 

  2. Caram PC, Carton CA, Scarcella G (1957) Intradural lipomas of the spinal cord; with particular emphasis on the intramedullary lipomas. J Neurosurg 14:28–42

    Article  CAS  PubMed  Google Scholar 

  3. Ehni G, Love J (1945) Intraspinal lipomas: report of cases; review of the literature, and clinical and pathologic study. J Nerv Ment Dis 102:520

    Google Scholar 

  4. Giuffre R (1966) Intradural spinal lipomas. Review of the literature (99 cases) and report of an additional case. Acta Neurochir (Wien) 14:69–95

    Article  CAS  Google Scholar 

  5. Lee M, Rezai AR, Abbott R, Coelho DH, Epstein FJ (1995) Intramedullary spinal cord lipomas. J Neurosurg 82:394–400

    Article  CAS  PubMed  Google Scholar 

  6. Bhatoe HS, Singh P, Chaturvedi A, Sahai K, Dutta V, Sahoo PK (2005) Nondysraphic intramedullary spinal cord lipomas: a review. Neurosurg Focus 18:ECP1

    Article  PubMed  Google Scholar 

  7. Rogers HM, Long DM, Chou SN, French LA (1971) Lipomas of the spinal cord and cauda equina. J Neurosurg 34:349–354

    Article  CAS  PubMed  Google Scholar 

  8. Dyck P (1992) Intramedullary lipoma. Diagnosis and treatment. Spine 17:979–981

    Article  CAS  PubMed  Google Scholar 

  9. Kim CH, Wang KC, Kim SK, Chung YN, Choi YL, Chi JG, Cho BK (2003) Spinal intramedullary lipoma: report of three cases. Spinal Cord 41:310–315

    Article  PubMed  Google Scholar 

  10. Mori K, Kamimura Y, Uchida Y, Kurisaka M, Eguchi S (1986) Large intramedullary lipoma of the cervical cord and posterior fossa. Case report. J Neurosurg 64:974–976

    Article  CAS  PubMed  Google Scholar 

  11. Pani KC, Chopra JS, Kak VK (1972) Intramedullary lipoma of the spinal cord. Neurochirurgia (Stuttg) 15:33–35

    CAS  Google Scholar 

  12. Patwardhan V, Patanakar T, Patkar D, Armao D, Mukherji SK (2000) MR imaging findings of intramedullary lipomas. AJR Am J Roentgenol 174:1792–1793

    CAS  PubMed  Google Scholar 

  13. Timmer FA, van Rooij WJ, Beute GN, Teepen JL (1996) Intramedullary lipoma. Neuroradiology 38:159–160

    Article  CAS  PubMed  Google Scholar 

  14. Blount JP, Elton S (2001) Spinal lipomas. Neurosurg Focus 10:e3

    Article  CAS  PubMed  Google Scholar 

  15. Wood BP, Harwood-Nash DC, Berger P, Goske M (1985) Intradural spinal lipoma of the cervical cord. AJR Am J Roentgenol 145:174–176

    CAS  PubMed  Google Scholar 

  16. McGillicuddy GT, Shucart W, Kwan ES (1987) Intradural spinal lipomas. Neurosurgery 21:343–346

    Article  CAS  PubMed  Google Scholar 

  17. Chagla AS, Balasubramaniam S, Goel AH (2008) A massive cervicomedullary intramedullary spinal cord lipoma. J Clin Neurosci 15:817–820

    Article  PubMed  Google Scholar 

  18. Chaskis C, Michotte A, Geffray F, Vangeneugden J, Desprechins B, D'Haens J (1997) Cervical intramedullary lipoma with intracranial extension in an infant. Case illustration. J Neurosurg 87:472

    Article  CAS  PubMed  Google Scholar 

  19. El Mostarchid B, Ali A, Maftah M, Mansouri A, Laghzioui J, Kadiri B, Gazzaz M, Chafiq M, Boucetta M (2002) Non-dysraphic intramedullary spinal cord lipoma. A case report. Jt Bone Spine 69:511–514

    Article  Google Scholar 

  20. Hoffmann G, Warot P, Galibert P, Meignie S, Laine ME (1960) Intramedullary lipomas of the cervicodorsal region. Rev Neurol (Paris) 103:558–567

    CAS  Google Scholar 

  21. Muthusubramanian V, Pande A, Vasudevan MC, Ramamurthi R (2008) Concomitant cervical and lumbar intradural intramedullary lipoma. Surg Neurol 69:314–317

    Article  PubMed  Google Scholar 

  22. Qureshi NA, Akram M, Ghaffar A, Bhatti S (2006) Non-dysraphic intramedullary spinal cord lipoma. J Coll Physicians Surg Pak 16:298–300

    PubMed  Google Scholar 

  23. Ammerman BJ, Henry JM, De Girolami U, Earle KM (1976) Intradural lipomas of the spinal cord. A clinicopathological correlation. J Neurosurg 44:331–336

    Article  CAS  PubMed  Google Scholar 

  24. Matsui H, Kanamori M, Miaki K (1997) Expansive laminoplasty for lumbar intradural lipoma. Int Orthop 21:185–187

    Article  CAS  PubMed  Google Scholar 

  25. Razack N, Jimenez OF, Aldana P, Ragheb J (1998) Intramedullary holocord lipoma in an athlete: case report. Neurosurgery 42:394–396, discussion 396–397

    Article  CAS  PubMed  Google Scholar 

  26. Catala M (1997) Embryogenesis. Why do we need a new explanation for the emergence of spina bifida with lipoma? Childs Nerv Syst 13:336–340

    Article  CAS  PubMed  Google Scholar 

  27. Iwatsuki K (2006) Intradural cervical lipoma with parenchymal marginal fibrous tissue: case report. Neurosurgery 59:E208, discussion E208

    Article  PubMed  Google Scholar 

  28. Lantos G, Epstein F, Kory LA (1987) Magnetic resonance imaging of intradural spinal lipoma. Neurosurgery 20:469–472

    Article  CAS  PubMed  Google Scholar 

  29. Drapkin AJ (1974) High cervical intradural lipoma. J Neurosurg 41:699–704

    Article  CAS  PubMed  Google Scholar 

  30. Fan CJ, Veerapen RJ, Tan CT (1989) Subdural spinal lipoma with posterior fossa extension. Clin Radiol 40:91–94

    Article  CAS  PubMed  Google Scholar 

  31. Endoh M, Iwasaki Y, Koyanagi I, Hida K, Abe H (1998) Spontaneous shrinkage of lumbosacral lipoma in conjunction with a general decrease in body fat: case report. Neurosurgery 43:150–151, discussion 151–152

    Article  CAS  PubMed  Google Scholar 

  32. Aoki N (1990) Rapid growth of intraspinal lipoma demonstrated by magnetic resonance imaging. Surg Neurol 34:107–110

    Article  CAS  PubMed  Google Scholar 

  33. Elsberg C (ed) (1925) Tumors of the spinal cord and the symptoms of irritation and compression of the spinal cord and nerve roots; pathology, symptomatology, diagnosis, and treatment. Paul B Hoeber New York

  34. Foster JJ (1966) Spinal intradural lipomas. A neurosurgical dilemma. Int Surg 46:480–486

    CAS  PubMed  Google Scholar 

  35. Swanson H, Barnett J (1962) Intradural lipomas in children. Pediatrics 29:911–926

    CAS  PubMed  Google Scholar 

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Correspondence to Syed Mohammed Rezaul Kabir.

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Kabir, S.M.R., Thompson, D., Rezajooi, K. et al. Non-dysraphic intradural spinal cord lipoma: case series, literature review and guidelines for management. Acta Neurochir 152, 1139–1144 (2010). https://doi.org/10.1007/s00701-010-0620-y

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  • DOI: https://doi.org/10.1007/s00701-010-0620-y

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