Rkhami Mouna, Kedous Mohamed Ali, Achoura Sameh, Zehani Alia, Bahri Kamel, Zammel Ihsen
Department of Neurosurgery, Burn and Trauma Center, Ben Arous, Université de Tunis El Manar, Tunisia.
Department of Orthopedics, Burn and Trauma Center Ben Arous, Université de Tunis El Manar, Tunisia.
Int J Surg Case Rep. 2018;45:72-76. doi: 10.1016/j.ijscr.2018.03.005. Epub 2018 Mar 15.
Angiolipomas are benign, slow growing lesions, almost always located subcutaneously in the trunc or limbs. They are composed of mature lipocytes admixed with abnormal blood vessels. Spinal epidural angiolipoma are rare accounting for approximately 0.14-1.2% of all spinal axis tumors and 2-3% of epidural spinal tumors.
We report the case of a 65 years-old-woman, presenting with complete paraplegia installed since 7 months. Magnetic resonance imaging (MRI) showed an epidural dorsal fatty mass. The patient recovered immediately after surgery. The pathological examination concluded to an angiolipoma.
Angiolipoma patients most commonly have long-lasting pain and then develop progressive neurological symptoms secondary to spinal cord compression. The mean duration of symptom progression at diagnosis is 1 year. MRI is the most reliable examination for the diagnosis of spinal angiolipoma. Total resection is the treatment of choice. No adjuvant treatment is indicated. Since SAL are very haemorrhagic lesions, preoperative embolization is recommended.
We think that spinal cord compression caused by angiolipoma have very good functional prognosis, even if tardily diagnosed.
血管脂肪瘤是一种良性、生长缓慢的病变,几乎总是位于躯干或四肢的皮下。它们由成熟的脂肪细胞与异常血管混合组成。脊髓硬膜外血管脂肪瘤很罕见,约占所有脊柱肿瘤的0.14 - 1.2%,占硬膜外脊柱肿瘤的2 - 3%。
我们报告一例65岁女性患者,自7个月前起出现完全性截瘫。磁共振成像(MRI)显示硬膜外背侧脂肪性肿块。患者术后立即康复。病理检查结果为血管脂肪瘤。
血管脂肪瘤患者最常见的是长期疼痛,随后继发于脊髓压迫出现进行性神经症状。诊断时症状进展的平均持续时间为1年。MRI是诊断脊髓血管脂肪瘤最可靠的检查方法。手术全切是首选治疗方法。无需辅助治疗。由于脊髓硬膜外血管脂肪瘤是出血性很强的病变,建议术前行栓塞治疗。
我们认为,即使诊断延迟,血管脂肪瘤引起的脊髓压迫仍具有很好的功能预后。