Intramedullary lipoma mimicking syringomyelia: A case report and literature review

Jialu  Wang; Penghao  Liu; Zan  Chen; Wanru  Duan

doi:10.37819/hb.2.326

Intramedullary lipoma mimicking syringomyelia: A case report and literature review

Jialu Wang

Penghao Liu

Zan Chen

Wanru Duan

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Abstract

Background： Intramedullary lipomas can sometimes be misdiagnosed as syringomyelia. In this report, we describe a case of intramedullary lipoma that presented with symptoms similar to syringomyelia and review the relevant literature.

Case presentation： A 35-year-old woman was admitted to the hospital due to hypoesthesia in her right limb, particularly in her leg. Spinal magnetic resonance imaging revealed a C5-T7 lesion and an L2–L3 lesion with hyperintensity in T1-weighted and T2-weighted image hypointensity in T1 fat suppression-weighted images. The lumbosacral lesion was resected, and the pathological results indicated cholesteatoma, while based on the clinical manifestation and imaging results, the cervicothoracic lesion was considered to be a lipoma and was observed without surgery. The patient's neurological function in the lower limb improved in 1 month after surgery.

Conclusion： Special caution should be exercised when attempting to differentiate between intramedullary lipoma and syringomyelia before surgery.

Keywords: Intramedullary lipoma Syringomyelia Surgical indications differentiation

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References

Fleming, K. L., Davidson, L., Gonzalez-Gomez, I. & McComb, J. G. Nondysraphic pediatric intramedullary spinal cord lipomas: report of 5 cases. Journal of neurosurgery. Pediatrics 5, 172-178, doi:10.3171/2009.9.peds09238 (2010).
Love, J. G., Daly, D. D. & Harris, L. E. Tight filum terminale. Report of condition in three siblings. Jama 176, 31-33, doi:10.1001/jama.1961.03040140033009 (1961).
Abul-Kasim, K., Thurnher, M. M., McKeever, P. & Sundgren, P. C. Intradural spinal tumors: current classification and MRI features. Neuroradiology 50, 301-314, doi:10.1007/s00234-007-0345-7 (2008).
Abuzayed, B., Alawneh, K., Al Qawasmeh, M. & Raffee, L. Nondysraphic spinal intramedullary lipoma: A rare case and management. Turkish archives of pediatrics 56, 85-87, doi:10.14744/TurkPediatriArs.2020.90187 (2021).
Guinto G, A. M., Ar´echiga N, et al. Different types of syringomyelia and their management: part I. Contemp Spine Surg 11, 1-7 (2010).
Flint, G. Syringomyelia: diagnosis and management. Practical neurology 21, 403-411, doi:10.1136/practneurol-2021-002994 (2021).
Goel, A. et al. Central atlantoaxial instability as a cause of syringomyelia mimic intramedullary lipoma. Journal of craniovertebral junction & spine 11, 152-154, doi:10.4103/jcvjs.JCVJS_65_20 (2020).
Arjipour, M., Ownagh, F. & Eftekharian, M. Fatty syringomyelia mimicking lipoma with spinal cord pilocytic astrocytoma. The neuroradiology journal, 19714009221140535, doi:10.1177/19714009221140535 (2022).
Massimi, L. et al. Acute presentations of intradural lipomas: case reports and a review of the literature. BMC neurology 19, 189, doi:10.1186/s12883-019-1413-4 (2019).
Pang, D. Commentary to the article: asymptomatic lumbosacral lipomas--a natural history study, by Wykes V, Desai D, and Thompson DNP. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 28, 1741-1742, doi:10.1007/s00381-012-1808-7 (2012).
Moghaddam, A. M., Tanriöver, N., Ulu, M. O., Muhammedrezai, S. & Akar, Z. Cervical intradural lipoma with associated hemivertebra formation at C6 level: a case report. Turkish neurosurgery 18, 187-190 (2008).
Roujeau, T., James, S., Forin, V. & Zerah, M. Results of the prophylactic surgery of lumbosacral lipomas: the pendulum of management? Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 33, 561-562, doi:10.1007/s00381-017-3345-x (2017).
Bhatoe, H. S. et al. Nondysraphic intramedullary spinal cord lipomas: a review. Neurosurgical focus 18, Ecp1, doi:10.3171/foc.2005.18.2.10 (2005).

How to Cite

“Intramedullary Lipoma Mimicking Syringomyelia: A Case Report and Literature Review”. Human Brain, vol. 2, no. 2, Mar. 2023, https://doi.org/10.37819/hb.2.326.

How to Cite

“Intramedullary Lipoma Mimicking Syringomyelia: A Case Report and Literature Review”. Human Brain, vol. 2, no. 2, Mar. 2023, https://doi.org/10.37819/hb.2.326.

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[1] Fleming, K. L., Davidson, L., Gonzalez-Gomez, I. & McComb, J. G. Nondysraphic pediatric intramedullary spinal cord lipomas: report of 5 cases. Journal of neurosurgery. Pediatrics 5, 172-178, doi:10.3171/2009.9.peds09238 (2010).

[2] Love, J. G., Daly, D. D. & Harris, L. E. Tight filum terminale. Report of condition in three siblings. Jama 176, 31-33, doi:10.1001/jama.1961.03040140033009 (1961).

[3] Abul-Kasim, K., Thurnher, M. M., McKeever, P. & Sundgren, P. C. Intradural spinal tumors: current classification and MRI features. Neuroradiology 50, 301-314, doi:10.1007/s00234-007-0345-7 (2008).

[4] Abuzayed, B., Alawneh, K., Al Qawasmeh, M. & Raffee, L. Nondysraphic spinal intramedullary lipoma: A rare case and management. Turkish archives of pediatrics 56, 85-87, doi:10.14744/TurkPediatriArs.2020.90187 (2021).

[5] Guinto G, A. M., Ar´echiga N, et al. Different types of syringomyelia and their management: part I. Contemp Spine Surg 11, 1-7 (2010).

[6] Flint, G. Syringomyelia: diagnosis and management. Practical neurology 21, 403-411, doi:10.1136/practneurol-2021-002994 (2021).

[7] Goel, A. et al. Central atlantoaxial instability as a cause of syringomyelia mimic intramedullary lipoma. Journal of craniovertebral junction & spine 11, 152-154, doi:10.4103/jcvjs.JCVJS_65_20 (2020).

[8] Arjipour, M., Ownagh, F. & Eftekharian, M. Fatty syringomyelia mimicking lipoma with spinal cord pilocytic astrocytoma. The neuroradiology journal, 19714009221140535, doi:10.1177/19714009221140535 (2022).

[9] Massimi, L. et al. Acute presentations of intradural lipomas: case reports and a review of the literature. BMC neurology 19, 189, doi:10.1186/s12883-019-1413-4 (2019).

[10] Pang, D. Commentary to the article: asymptomatic lumbosacral lipomas--a natural history study, by Wykes V, Desai D, and Thompson DNP. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 28, 1741-1742, doi:10.1007/s00381-012-1808-7 (2012).

[11] Moghaddam, A. M., Tanriöver, N., Ulu, M. O., Muhammedrezai, S. & Akar, Z. Cervical intradural lipoma with associated hemivertebra formation at C6 level: a case report. Turkish neurosurgery 18, 187-190 (2008).

[12] Roujeau, T., James, S., Forin, V. & Zerah, M. Results of the prophylactic surgery of lumbosacral lipomas: the pendulum of management? Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 33, 561-562, doi:10.1007/s00381-017-3345-x (2017).

[13] Bhatoe, H. S. et al. Nondysraphic intramedullary spinal cord lipomas: a review. Neurosurgical focus 18, Ecp1, doi:10.3171/foc.2005.18.2.10 (2005).