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Spinal Angiolipoma

  • Daryl R. Fourney (a1), Karen A. Tong (a2), Robert J.B. Macaulay (a3) and Robert W. Griebel (a1)
Abstract:
ABSTRACT: Background:

Spinal epidural angiolipoma is a rare cause of spinal cord compression. We present a case and review the clinical presentation, radiological appearance, pathological aspects and treatment of this distinct clinico-pathological entity.

Methods:

A case of a 46-year-old woman with a five-month history of progressive myelopathy affecting her lower extremities is presented. CT and MRI revealed a large epidural fat-containing mass compressing the spinal cord dorsally at the T7-T8 level. A laminectomy was performed with gross total resection of the lesion.

Results:

The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has revealed no signs of tumor recurrence and no neurological deficit.

Conclusion:

The diagnosis of spinal angiolipoma should be considered in the differential diagnosis of spinal cord compression. Magnetic resonance imaging is the investigation of choice. The surgical objective is complete excision but, for anterior lesions involving bone, an overly aggressive approach should be tempered by an awareness of the overall indolent natural history of so-called "infiltrating" spinal angiolipomas that are only partially excised.

RÉSUMÉ: Introduction:

L'angiolipome épidural spinal est une cause rare de compression de la moelle épinière. Nous présentons un cas et nous revoyons la présentation clinique, les aspects radiologiques et anatomopathologiques ainsi que le traitement de cette entité clinico-pathologique distincte.

Méthodes:

Nous décrivons le cas d'une femme de 46 ans ayant une histoire de myélopathie progressive affectant ses membres inférieurs, évoluant depuis 5 mois. La tomodensitométrie et la résonance magnétique nucléaire ont montré une grosse masse épidurale contenant de la graisse et comprimant la moelle épinière au niveau de D7-D8. Une laminectomie a été effectuée avec exérèse de la lésion.

Résultats:

Les symptômes neurologiques de la patiente se sont améliorés après la chirurgie. Deux ans après, il n'y a aucun signe de récidive de la tumeur et pas de déficit neurologique.

Conclusion:

Le diagnostic d'angiolipome devrait faire partie du diagnostic différentiel dans la compression de la moelle épinière. L'imagerie par résonance magnétique est l'investigation de choix. L'objectif chirurgical est l'excision totale de la tumeur mais, quand il s'agit de lésions antérieures impliquant les structures osseuses, une approche agressive devrait être tempérée par la notion que les angiolipomes spinaux soit disant infiltrants ont une histoire naturelle plutôt indolente s'ils ne sont pas réséqués complètement.

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Copyright
Corresponding author
Division of Neurosurgery, Royal University Hospital, 103 Hospital Drive, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada S7N 0W8
References
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1. Ehni G, Love JG. Intraspinal lipomas. Arch Neurol Psychiatry 1945; 53:128.
2. Russell DS, Rubenstein LJ. Pathology of Tumors of the Nervous System. Baltimore: Williams & Wilkins, 1989:706708.
3. Haddad FS, Abla A, Allam CK. Extradural spinal angiolipoma. Surg Neurol 1986; 26:473486.
4. Preul MC, Leblanc R, Tampieri D, Robitalle Y, Pokrupa R. Spinal angiolipomas: report of three cases. J Neurosurg 1993; 78:280286.
5. Liebscher C. Angiolipom des Wirbelkanals mit Kompresion des Ruckenmarkes. Prag Med Wochenschr 1901; 26:189191.
6. Berenbruch K. Ein Fall von multiple Angio-lipomen kombiniert mit einem Angiom des Ruckenmarks. Tibingen, 1890.
7. Frazier CH, Allen AR. Surgery of the Spine and Spinal Cord. New York: Appelton, 1918;521, 523, 538.
8. Elsberg CA. Extradural spinal tumors – primary, secondary, metastatic. Surg Gynecol Obstet 1928; 46:120.
9. Kasper JA, Cowan A. Extradural lipoma of the spinal canal. Arch Pathol 1929; 8:800802.
10. Petit-Dutaillis D, Christoph J. Compression medullaire par volumineux angio-lipome extradural. Ablation chirurgicale. Guerison. Rev Neurol (Paris) 1931; 2:824827.
11. Bucy PC, Ritchey H. Klippel-Feil’s syndrome associated with compression of the spinal cord by an extradural hemangiolipoma. J Neurosurg 1947; 4:476481.
12. Taylor J, Harries BJ, Schurr PH. Extrathecal hemangiolipomas of the spinal canal. Br J Surg 1951; 39:17.
13. Lo Re, Michelacci M. Considerazioni cliniche e chirurgiche su alcune malformazioni congenite vertebrali lombosacrali associate ad angiolipoma. Arch Putti Chir Organi 1969; 24:7085.
14. Pearson J, Stellar S, Feigin I. Angiomyolipoma: long-term cure following radical approach to malignant-appearing benign intraspinal tumor. Report of 3 cases. J Neurosurg 1970; 33:466470.
15. Henry P, Vital C, Vallat JM, Briole G, Loiseau P. Etude anatomoclinique d’un angiolipome extradural associe a un glioblastome intramedullaire. Rev Neurol (Paris) 1971; 124:385391.
16. Bender JL, Van Landingham JH, Manno NJ. Epidural lipoma producing spinal cord compression. J Neurosurg 1974; 41:100103.
17. Occhiogrosso M, Vailati G. Compressione midollare da angiolipoma epidurale: descrizione di un caso. Acta Neurol (Napoli) 1977; 32:850853.
18. Obrador S, Villarejo F, Deblas A. Angiolipoma extradural: causa infrecuente de compresion medular. Rev Clin Esp 1977; 146:395396.
19. Cull DJ, Evdohazi M, Symon L. Extradural hemangiolipomas in the spinal canal. Two cases presenting during pregnancy. Acta Neurochir (Wein) 1978; 45:187193.
20. Shuangshoti S, Hongsaprabhas C. Intraspinal epidural angiolipoma. J Med Assoc Thai 1979; 62:457460.
21. Schiffer J, Gilboa Y, Ariazoroff A. Epidural angiolipoma producing compression of the cauda equina. Neurochirurgia 1980;23:117120.
22. Miki T, Oka M, Shima M, Hirofuji E, Tanaka S. Spinal angiolipoma: a case report. Acta Neurochir (Wien) 1981; 58:115119.
23. Padovani R, Tognetti F, Speranza S, Pozzati E. Spinal extrathecal hemangiolipomas: report of two cases and review of the literature. Neurosurgery 1982; 11:674677.
24. Griebel RW, Khan M, Rozdilsky B. Spinal extradural angiolipoma: a case report and literature review. Spine 1986; 11:4748.
25. Nishiura I, Kubo Y, Koyama T. Spinal haemangiolipoma: three case reports. Neurochirurgia 1986; 29:6366.
26. Matshushima K, Shinohara Y, Yamamoto M, et al. Spinal extradural angiolipoma: MR and CT diagnosis. J Comput Assist Tomogr 1987; 11:11041106.
27. Poon TP, Behbanhani M, Matoso IM, Katz MA, Pearl M. Epidural angiolipoma with spinal cord compression. J Natl Med Assoc 1988; 80:347349.
28. Anson JA, Cybulski GR, Reyes M. Spinal extradural angiolipoma: a report of two cases and review of the liturature. Surg Neurol 1990; 34:173178.
29. Mascalchi M, Arnetoli G, Dal Pozzo G, Canavero S, Pagni CA. Spinal epidural angiolipoma: MR findings. AJNR Am J Neuroradiol 1991; 12:744745.
30. Weill A, Carpio-O’Donovan R, Tampieri D, Melanson D, Ethier R. Spinal angiolipomas: CT and MR aspects. J Comput Assist Tomogr 1991; 15:8385.
31. Stranjalis G, Jamjoom A, Torrens MJ. MRI in the diagnosis of spinal extradural angiolipoma. Br J Neurosurg 1992; 6:481483.
32. Pagni CA, Canavero S. Spinal epidural angiolipoma. Rare or underreported? Neurosurgery 1992; 31:758764.
33. Rubin G, Gornish M, Sandbank J, Shevach I, Rappaport ZH. Spinal extradural angiolipoma: case report and review of the literature. Spine 1992; 17:719724.
34. Shibata Y, Sugimoto K, Matsuki T, Nose T. Thoracic epidural angiolipoma: case report. Neurol Med Chir (Tokyo) 1993; 33:316319.
35. Yamashita K, Fugi T, Nakai T, Hamada H, Kotoh K. Extradural spinal angiolipoma: a report of a case studied with MRI. Surg Neurol 1993; 39:4952.
36. Bouramas D, Korres DS, Roussos L, Mantzilas T, Anagnostopoulos D. Spinal extradural angiolipoma. J Spinal Disord 1995; 8:324327.
37. O’Donovan NA, Kirtikumar N, Maloney WJ, Llewellyn CG. Spinal angiolipoma mimicking extradural lipomatosis. Can Assoc Radiol J 1996; 47:5153.
38. Provenzale JM, McLendon RE. Spinal angiolipomas: MR features. AJNR Am J Neuroradiol 1996; 17:713719.
39. Trabulo A, Cerqueira J, Monteiro P, et al. Spinal angiolipomas revisited: two case reports. Acta Neurochir (Wien) 1996; 138:13111319.
40. Bala Krishnan V, Law AJJ, Kenwright DN. Spinal extradural angiolipoma. Aust NZ J Surg 1996; 66:194196.
41. Boockvar JA, Black K, Malik S, Stanek A, Tracey KJ. Subacute paraparesis induced by venous thrombosis of a spinal angiolipoma: a case report. Spine 1997; 22:23042308.
42. Shuangshoti S, Lerdlum S. Concurrent occurrence of solitary spinal epidural osteochondroma and angiolipoma. Clin Neuropathol 1997; 16:107110.
43. Oge HK, Soylemezoglu F, Rousan N, Ozcan OE. Spinal angiolipoma: case report and review of literature. J Spinal Disord 1999; 12:353356.
44. Labram EK, El-Shunnar K, Hilton DA, Robertson NJ. Revisited: spinal angiolipoma-three additional cases. Br J Neurosurg 1999; 13:2529.
45. Turgut M. Spinal angiolipomas: report of a case and review of the cases published since the discovery of the tumor in 1890. Br J Neurosurg 1999; 13:3040.
46. Gonzalez-Crussi F, Enneking WF, Arean VM. Infiltrating angiolipoma. J Bone Joint Surg (Am) 1966; 48A:11111124.
47. Von Hanwehr R, Apuzzo MLJ, Ahmadi J, Chandrasoma P. Thoracic spinal angiomyolipoma: case report and literature review. Neurosurgery 1985; 16:406411.
48. Rivkind A, Margulies JY, Lebensart P, Sherman Y, Robin GC. Anterior approach for removal of spinal angiolipoma: a case report. Spine 1986; 11:623625.
49. Kuroda S, Hiroshi A, Akino M, Iwasaki Y, Nagashima K. Infiltrating spinal angiolipoma causing myelopathy: case report. Neurosurgery 1990; 27:315318.
50. Sakaida H, Waga S, Kojima T, et al. Thoracic spinal angiolipoma with extracanal extension to the thoracic cavity: a case report. Spine 1998; 23:391394.
51. Kujas M, Lopes M, Lalam TF, Fohanno D, Poirier J. Infiltrating extradural spinal angiolipoma. Clin Neuropath 1999; 8:9398.
52. Palkovic S, Wassmann H, Bonse R, Kashab M. Angiolipoma of the spinal cord: magnetic resonance imaging and microsurgical management. Surg Neurol 1989; 29:243245.
53. Maggi G, Alberti F, Colucci MR, et.al. Spinal intramedullary angiolipoma. Childs Nerv Syst 1996; 12:346349.
54. Klisch J, Spreer J, Bloss HG, Baborie A, Hubbe U. Radiological and histological findings in spinal intramedullary angiolipoma. Neuroradiology 1999; 41:584587.
55. Lin JJ, Lin F. Two entities in angiolipomas. A study of 459 cases of lipoma with review of the literature on infiltrating angiolipoma. Cancer 1974; 34:720727.
56. Thomas J, Miller R. Lipomatous tumors of the spinal canal. Mayo Clin Proc 1973; 48:393400.
57. Pirotte B, Krischek B, Levivier M, et al. Diagnostic and microsurgical presentation of intracranial angiolipomas: case report and review of the literature. J Neurosurg 1998; 88:129132.
58. Willis RA. Pathology of Tumors. London: Butterworths, 1948:700.
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Canadian Journal of Neurological Sciences
  • ISSN: 0317-1671
  • EISSN: 2057-0155
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