Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-24T08:10:04.455Z Has data issue: false hasContentIssue false
  • English
  • Français

Spinal Angiolipoma

Published online by Cambridge University Press:  02 March 2017

Daryl R. Fourney ,
Karen A. Tong ,
Robert J.B. Macaulay  and
Robert W. Griebel
Daryl R. Fourney*
Affiliation:
Division of Neurosurgery, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Karen A. Tong
Affiliation:
Department of Radiology, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Robert J.B. Macaulay
Affiliation:
Department of Pathology, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
Robert W. Griebel
Affiliation:
Division of Neurosurgery, Royal University Hospital, Royal University Hospital, Saskatoon, Saskatchewan, Canada
*
Division of Neurosurgery, Royal University Hospital, 103 Hospital Drive, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada S7N 0W8
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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:

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.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 1 , February 2001 , pp. 82 - 88
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

REFERENCES

1. Ehni, G, Love, JG. Intraspinal lipomas. Arch Neurol Psychiatry 1945; 53:1–28.CrossRefGoogle Scholar
2. Russell, DS, Rubenstein, LJ. Pathology of Tumors of the Nervous System. Baltimore: Williams & Wilkins, 1989:706–708.Google Scholar
3. Haddad, FS, Abla, A, Allam, CK. Extradural spinal angiolipoma. Surg Neurol 1986; 26:473–486.Google Scholar
4. Preul, MC, Leblanc, R, Tampieri, D, Robitalle, Y, Pokrupa, R. Spinal angiolipomas: report of three cases. J Neurosurg 1993; 78:280–286.CrossRefGoogle ScholarPubMed
5. Liebscher, C. Angiolipom des Wirbelkanals mit Kompresion des Ruckenmarkes. Prag Med Wochenschr 1901; 26:189–191.Google Scholar
6. Berenbruch, K. Ein Fall von multiple Angio-lipomen kombiniert mit einem Angiom des Ruckenmarks. Tibingen, 1890.Google Scholar
7. Frazier, CH, Allen, AR. Surgery of the Spine and Spinal Cord. New York: Appelton, 1918;521, 523, 538.Google Scholar
8. Elsberg, CA. Extradural spinal tumors – primary, secondary, metastatic. Surg Gynecol Obstet 1928; 46:1–20.Google Scholar
9. Kasper, JA, Cowan, A. Extradural lipoma of the spinal canal. Arch Pathol 1929; 8:800–802.Google Scholar
10. Petit-Dutaillis, D, Christoph, J. Compression medullaire par volumineux angio-lipome extradural. Ablation chirurgicale. Guerison. Rev Neurol (Paris) 1931; 2:824–827.Google Scholar
11. Bucy, PC, Ritchey, H. Klippel-Feil’s syndrome associated with compression of the spinal cord by an extradural hemangiolipoma. J Neurosurg 1947; 4:476–481.Google Scholar
12. Taylor, J, Harries, BJ, Schurr, PH. Extrathecal hemangiolipomas of the spinal canal. Br J Surg 1951; 39:1–7.CrossRefGoogle Scholar
13. Lo, Re, Michelacci, M. Considerazioni cliniche e chirurgiche su alcune malformazioni congenite vertebrali lombosacrali associate ad angiolipoma. Arch Putti Chir Organi 1969; 24:70–85.Google Scholar
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; 33:466–470.Google Scholar
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; 124:385–391.Google Scholar
16. Bender, JL, Van Landingham, JH, Manno, NJ. Epidural lipoma producing spinal cord compression. J Neurosurg 1974; 41:100–103.Google Scholar
17. Occhiogrosso, M, Vailati, G. Compressione midollare da angiolipoma epidurale: descrizione di un caso. Acta Neurol (Napoli) 1977; 32:850–853.Google Scholar
18. Obrador, S, Villarejo, F, Deblas, A. Angiolipoma extradural: causa infrecuente de compresion medular. Rev Clin Esp 1977; 146:395–396.Google Scholar
19. Cull, DJ, Evdohazi, M, Symon, L. Extradural hemangiolipomas in the spinal canal. Two cases presenting during pregnancy. Acta Neurochir (Wein) 1978; 45:187–193.Google Scholar
20. Shuangshoti, S, Hongsaprabhas, C. Intraspinal epidural angiolipoma. J Med Assoc Thai 1979; 62:457–460.Google Scholar
21. Schiffer, J, Gilboa, Y, Ariazoroff, A. Epidural angiolipoma producing compression of the cauda equina. Neurochirurgia 1980;23:117–120.Google Scholar
22. Miki, T, Oka, M, Shima, M, Hirofuji, E, Tanaka, S. Spinal angiolipoma: a case report. Acta Neurochir (Wien) 1981; 58:115–119.CrossRefGoogle ScholarPubMed
23. Padovani, R, Tognetti, F, Speranza, S, Pozzati, E. Spinal extrathecal hemangiolipomas: report of two cases and review of the literature. Neurosurgery 1982; 11:674–677.CrossRefGoogle ScholarPubMed
24. Griebel, RW, Khan, M, Rozdilsky, B. Spinal extradural angiolipoma: a case report and literature review. Spine 1986; 11:47–48.Google Scholar
25. Nishiura, I, Kubo, Y, Koyama, T. Spinal haemangiolipoma: three case reports. Neurochirurgia 1986; 29:63–66.Google ScholarPubMed
26. Matshushima, K, Shinohara, Y, Yamamoto, M, et al. Spinal extradural angiolipoma: MR and CT diagnosis. J Comput Assist Tomogr 1987; 11:1104–1106.Google Scholar
27. Poon, TP, Behbanhani, M, Matoso, IM, Katz, MA, Pearl, M. Epidural angiolipoma with spinal cord compression. J Natl Med Assoc 1988; 80:347–349.Google ScholarPubMed
28. Anson, JA, Cybulski, GR, Reyes, M. Spinal extradural angiolipoma: a report of two cases and review of the liturature. Surg Neurol 1990; 34:173–178.Google Scholar
29. Mascalchi, M, Arnetoli, G, Dal Pozzo, G, Canavero, S, Pagni, CA. Spinal epidural angiolipoma: MR findings. AJNR Am J Neuroradiol 1991; 12:744–745.Google Scholar
30. Weill, A, Carpio-O’Donovan, R, Tampieri, D, Melanson, D, Ethier, R. Spinal angiolipomas: CT and MR aspects. J Comput Assist Tomogr 1991; 15:83–85.CrossRefGoogle ScholarPubMed
31. Stranjalis, G, Jamjoom, A, Torrens, MJ. MRI in the diagnosis of spinal extradural angiolipoma. Br J Neurosurg 1992; 6:481–483.Google Scholar
32. Pagni, CA, Canavero, S. Spinal epidural angiolipoma. Rare or underreported? Neurosurgery 1992; 31:758–764.Google ScholarPubMed
33. Rubin, G, Gornish, M, Sandbank, J, Shevach, I, Rappaport, ZH. Spinal extradural angiolipoma: case report and review of the literature. Spine 1992; 17:719–724.Google Scholar
34. Shibata, Y, Sugimoto, K, Matsuki, T, Nose, T. Thoracic epidural angiolipoma: case report. Neurol Med Chir (Tokyo) 1993; 33:316–319.Google Scholar
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; 39:49–52.CrossRefGoogle ScholarPubMed
36. Bouramas, D, Korres, DS, Roussos, L, Mantzilas, T, Anagnostopoulos, D. Spinal extradural angiolipoma. J Spinal Disord 1995; 8:324–327.Google Scholar
37. O’Donovan, NA, Kirtikumar, N, Maloney, WJ, Llewellyn, CG. Spinal angiolipoma mimicking extradural lipomatosis. Can Assoc Radiol J 1996; 47:51–53.Google Scholar
38. Provenzale, JM, McLendon, RE. Spinal angiolipomas: MR features. AJNR Am J Neuroradiol 1996; 17:713–719.Google Scholar
39. Trabulo, A, Cerqueira, J, Monteiro, P, et al. Spinal angiolipomas revisited: two case reports. Acta Neurochir (Wien) 1996; 138:1311–1319.CrossRefGoogle ScholarPubMed
40. Bala Krishnan, V, Law, AJJ, Kenwright, DN. Spinal extradural angiolipoma. Aust NZ J Surg 1996; 66:194–196.CrossRefGoogle Scholar
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; 22:2304–2308.Google Scholar
42. Shuangshoti, S, Lerdlum, S. Concurrent occurrence of solitary spinal epidural osteochondroma and angiolipoma. Clin Neuropathol 1997; 16:107–110.Google ScholarPubMed
43. Oge, HK, Soylemezoglu, F, Rousan, N, Ozcan, OE. Spinal angiolipoma: case report and review of literature. J Spinal Disord 1999; 12:353–356.Google Scholar
44. Labram, EK, El-Shunnar, K, Hilton, DA, Robertson, NJ. Revisited: spinal angiolipoma-three additional cases. Br J Neurosurg 1999; 13:25–29.Google Scholar
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; 13:30–40.Google Scholar
46. Gonzalez-Crussi, F, Enneking, WF, Arean, VM. Infiltrating angiolipoma. J Bone Joint Surg (Am) 1966; 48A:1111–1124.Google Scholar
47. Von Hanwehr, R, Apuzzo, MLJ, Ahmadi, J, Chandrasoma, P. Thoracic spinal angiomyolipoma: case report and literature review. Neurosurgery 1985; 16:406–411.Google Scholar
48. Rivkind, A, Margulies, JY, Lebensart, P, Sherman, Y, Robin, GC. Anterior approach for removal of spinal angiolipoma: a case report. Spine 1986; 11:623–625.Google Scholar
49. Kuroda, S, Hiroshi, A, Akino, M, Iwasaki, Y, Nagashima, K. Infiltrating spinal angiolipoma causing myelopathy: case report. Neurosurgery 1990; 27:315–318.Google Scholar
50. Sakaida, H, Waga, S, Kojima, T, et al. Thoracic spinal angiolipoma with extracanal extension to the thoracic cavity: a case report. Spine 1998; 23:391–394.Google Scholar
51. Kujas, M, Lopes, M, Lalam, TF, Fohanno, D, Poirier, J. Infiltrating extradural spinal angiolipoma. Clin Neuropath 1999; 8:93–98.Google Scholar
52. Palkovic, S, Wassmann, H, Bonse, R, Kashab, M. Angiolipoma of the spinal cord: magnetic resonance imaging and microsurgical management. Surg Neurol 1989; 29:243–245.Google Scholar
53. Maggi, G, Alberti, F, Colucci, MR, et.al. Spinal intramedullary angiolipoma. Childs Nerv Syst 1996; 12:346–349.Google Scholar
54. Klisch, J, Spreer, J, Bloss, HG, Baborie, A, Hubbe, U. Radiological and histological findings in spinal intramedullary angiolipoma. Neuroradiology 1999; 41:584–587.CrossRefGoogle ScholarPubMed
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; 34:720–727.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
56. Thomas, J, Miller, R. Lipomatous tumors of the spinal canal. Mayo Clin Proc 1973; 48:393–400.Google Scholar
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; 88:129–132.Google Scholar
58. Willis, RA. Pathology of Tumors. London: Butterworths, 1948:700.Google Scholar