Fourney D R, Tong K A, Macaulay R J, Griebel R W
Division of Neurosurgery, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Can J Neurol Sci. 2001 Feb;28(1):82-8. doi: 10.1017/s0317167100052628.
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.
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.
The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has revealed no signs of tumor recurrence and no neurological deficit.
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.
脊髓硬膜外血管脂肪瘤是脊髓压迫症的一种罕见病因。我们报告一例病例，并对这种独特的临床病理实体的临床表现、影像学表现、病理特征及治疗进行综述。
报告一例46岁女性患者，有5个月进行性脊髓病病史，累及双下肢。CT和MRI显示T7-T8水平有一个巨大的含硬膜外脂肪肿块，从背侧压迫脊髓。行椎板切除术并对病变进行大体全切。
患者术后神经症状改善。两年随访期未发现肿瘤复发迹象及神经功能缺损。
在脊髓压迫症的鉴别诊断中应考虑脊髓血管脂肪瘤的诊断。磁共振成像为首选检查方法。手术目标是完整切除，但对于累及骨质的前部病变，鉴于所谓“浸润性”脊髓血管脂肪瘤整体惰性的自然病程，即便只能部分切除，过于激进的手术方式也应有所节制。
