Shimogawa Takafumi, Morioka Takato, Murakami Nobuya, Mukae Nobutaka, Hashiguchi Kimiaki, Suzuki Satoshi O, Iihara Koji
Department of Neurosurgery, Fukuoka Children's Hospital, Fukuoka, Japan.
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Pediatr Neurosurg. 2018;53(5):305-310. doi: 10.1159/000490391. Epub 2018 Jul 4.
It is well known that bony and cartilaginous tissues can be present in lumbosacral lipomas; however, the relationship between their presence and clinical features has not been demonstrated.
Five (10.4%) out of 48 patients had osteochondral tissues in lipomas. We retrospectively analyzed the clinical, neuroradiological, and histological findings of these patients.
Five (45.5%) of 11 patients with dorsal and transitional type lipomas had osteochondral tissues, while none with caudal and filar type lipomas had these tissues. Presurgical imaging demonstrated that the osteochondral tissue was located in a large subcutaneous lipoma dorsal to the bifid vertebral column. Histologically, mature bone with hematopoietic marrow and hyaline cartilage were observed in 3 and 2 patients, respectively.
The high incidence of association of osteochondral tissues with dorsal and transitional type lipomas is thought to be the result of primary neurulation failure with invasion of mesenchymal tissues. Caudal and filar type lipomas, resulting from secondary neurulation failure, thus did not have osteochondral tissue.
众所周知，腰骶部脂肪瘤中可存在骨组织和软骨组织；然而，它们的存在与临床特征之间的关系尚未得到证实。
48例患者中有5例（10.4%）脂肪瘤中存在骨软骨组织。我们回顾性分析了这些患者的临床、神经放射学和组织学检查结果。
11例背侧及过渡型脂肪瘤患者中有5例（45.5%）存在骨软骨组织，而尾侧及终丝型脂肪瘤患者均无此类组织。术前影像学检查显示，骨软骨组织位于双裂脊柱背侧的一个巨大皮下脂肪瘤内。组织学检查发现，分别有3例和2例患者观察到含有造血骨髓的成熟骨和透明软骨。
骨软骨组织与背侧及过渡型脂肪瘤的高关联率被认为是原始神经形成失败并伴有间充质组织侵入的结果。由继发神经形成失败导致的尾侧及终丝型脂肪瘤则没有骨软骨组织。
