Ramdurg Shashank Ravindra
Department of Neurosurgery, MR Medical College, Kalaburagi, Karnataka, India.
J Pediatr Neurosci. 2017 Jan-Mar;12(1):43-45. doi: 10.4103/1817-1745.205644.
Lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients. Sixty-six percent of lipomyelomeningocele in young patients have accompanied by hypertrophic filum terminale. It is rare to find two isolated spinal lipomas simultaneously. Embryological origin of dorsal and filar lipomas is different from each other and hence rarer to find them together. Radical resection is now being preferred for better long-term progression-free survival. We report an interesting case of spinal dysraphism in a 4-month-old female child with protruding, nontender, soft, subcutaneous 5 cm × 7 cm mass of the lumbosacral area that had been present since birth. Other anomalies included polydactyly of left hand. Magnetic resonance imaging demonstrated two isolated spinal lipomas, a transitional type and a terminal type filum lipoma with an interval of normal filum between the two. The findings were confirmed at surgery and detethering done along the white plane with neural placode reconstruction as described by Dachling Pang. The child had an uneventful postoperative recovery.
据报道，腰骶部脂肪瘤在每10万名患者中的发病率为4至8例。年轻患者中66%的脂肪脊髓脊膜膨出伴有终丝增粗。同时发现两个孤立性脊髓脂肪瘤的情况很罕见。背侧和终丝脂肪瘤的胚胎起源不同，因此同时发现它们的情况更为罕见。为了获得更好的长期无进展生存期，目前更倾向于进行根治性切除。我们报告了一例有趣的脊髓发育异常病例，一名4个月大的女童，腰骶部有一个自出生以来就存在的突出、无压痛、柔软的皮下5厘米×7厘米肿块。其他异常包括左手多指畸形。磁共振成像显示两个孤立性脊髓脂肪瘤，一个是过渡型，一个是终丝型脂肪瘤，两者之间有一段正常的终丝。手术中证实了这些发现，并按照达克林·庞描述的方法沿着白质平面进行松解并重建神经基板。患儿术后恢复顺利。
