Spinal Angiolipoma: Diagnosis and Treatment
Spinal angiolipomas are benign uncommon neoplasms originating in mesenchymal tissue, and are composed of mature lipocytes admixed with abnormal blood vessels. Angiolipomas frequently develop in the epidural space of the spine and more rarely in the orbit, the cavernous spaces, thalamus, and account for only 0.04–1.2% of all spinal tumors. These neoplasms can be categorized into two subtypes: non-infiltrating and infiltrating. The former is more common and remains confined to the epidural space whereas the latter invades the contiguous bone and adjacent soft tissues.
Spinal angiolipomas are predominantly located in the mid-thoracic region; hence, most patients present slowly progressive signs of spinal cord compression secondary to epidural mass. Angiolipomas show iso- or hyperintensity on T1-weighted images and hyperintensity on T2-weighted images, and most lesions enhance with gadolinium administration. The treatment for spinal extradural angiolipomas is surgical resection. Complete removal of an epidural non-infiltrating angiolipoma is possible in most cases and the prognosis is excellent and no adjuvant therapy should be administered. For infiltrating neo plasms complete removal may entail complications due to heavy bleeding.
KeywordsSpinal Canal Epidural Space Spinal Tumor Vertebral Hemangioma Spinal Lipoma
- Balado M, Morea R (1928) Extramedular haemangioma producing paraplegia during pregnancy. Arch Argent Neurol 1:345–351Google Scholar
- Berenbruch K (1890) Association of multiples angiolipomas and angioma of spinal cord, Tubingen: H Laupp, JrGoogle Scholar
- Gonzalez-Crussi F, Enneking WF, Arean VM (1966) Infiltrating angiolipoma. J Bone Joint Surg Am 48A:1111–1124Google Scholar
- Liebscher C (1901) Angiolipoma of the spinal canal with compression of the spinal cord. Pag Med Wochenschr 26:189–191Google Scholar
- Nishiura I, Kubo Y, Koyama T (1986) Spinal haemangiolipoma: three case reports. Neurochirurgia (Stuttg) 29:63–66Google Scholar
- Sciot R, Akerman M, Dal Cin P, De Wever I, Fletcher CD, Mandahl N, Mertens F, Mitelman F, Rosai J, Rydholm A, Tallini G, Van den Berghe H, Vanni R, Willen H (1997) Cytogenic analysis of subcutaneous angiolipoma: further evidence supporting its difference from ordinary pure lipomas. A report of the CHAMP Study Group. Am J Surg Pathol 21:441–444PubMedCrossRefGoogle Scholar
- Turanzas FS, Domínguez J, Eyerbe P, Dhimes P (1994) Infiltrating spinal angiolipoma. Case report. Neurocirugia 5:246–249Google Scholar
- Willis RA (1948) Pathology of tumors. Butterworths, London, p 700Google Scholar