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[脊髓硬膜外血管脂肪瘤:脊髓压迫的罕见原因。8例报告并文献复习]

[Spinal epidural angiolipomas: a rare cause of spinal cord compression. A report of 8 cases and review of the literature].

作者信息

Akhaddar A, Gazzaz M, Derraz S, Rifi L, Amarti A, Aghzadi A

机构信息

Service de Neurochirurgie, Hôpital des Spécialités ONO, Rabat, Maroc.

出版信息

Neurochirurgie. 2000 Dec;46(6):523-533.

Abstract

Extradural spinal angiolipomas are rare benign tumors containing vascular and mature adipose elements. We report 8 cases of spinal epidural angiolipomas in 6 females and 2 males. In 7 cases, the clinical manifestation was a progressive spinal cord compression and one case had a regressive paraparesis mimicking a multiple sclerosis. In the 8 cases, the localization was thoracic with an extradural complete type of contrast block in 2 cases and partial in 5 cases. The myelo-CT achieved in 7 cases and the magnetic resonance imaging done at our last case revealed a fat-containing epidural tumor. The tumors were removed in all cases through a laminectomy with a successful outcome after an average of 9 years (range: 6 months-12 years). Sixty-seven similar cases in the international literature are reviewed. A total of 75 cases have been studied: 45 women and 30 men with a mean age of 46.3 years (range: 6-73), presenting a progressive spinal cord compression in 68 cases and in 7 cases a regressive paraparesis mimicking a multiple sclerosis. Myelography shows an extradural compression of the thecal sac. MRI is nowadays the imaging modality of choice for the diagnosis of these lesions. The surgical removal often easy of the epidural spinal angiolipomas permit a fast recovery. The etiopathogenesis of this process is still controversial between the dysembryogenetic and malformative hypothesis.

摘要

硬脊膜外脊髓血管脂肪瘤是一种罕见的良性肿瘤,由血管和成熟脂肪成分组成。我们报告了8例脊髓硬脊膜外血管脂肪瘤病例,其中6例为女性,2例为男性。7例患者的临床表现为进行性脊髓压迫,1例患者出现类似多发性硬化症的进行性轻截瘫。8例患者的病变均位于胸段,2例为硬脊膜外完全性造影剂阻滞,5例为部分性阻滞。7例行脊髓CT检查,最后1例行磁共振成像检查,均显示硬脊膜外含脂肪肿瘤。所有病例均通过椎板切除术切除肿瘤,平均9年(范围:6个月至12年)后取得成功。我们回顾了国际文献中的67例类似病例。共研究了75例:45例女性和30例男性,平均年龄46.3岁(范围:6至73岁),68例表现为进行性脊髓压迫,7例表现为类似多发性硬化症的进行性轻截瘫。脊髓造影显示硬脊膜囊硬脊膜外受压。如今,MRI是诊断这些病变的首选影像学检查方法。硬脊膜外脊髓血管脂肪瘤通常易于手术切除,术后恢复迅速。该疾病的病因在胚胎发育异常和畸形假说之间仍存在争议。

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