Pasalic Ivan, Brgic Klara, Nemir Jakob, Kolenc Danijela, Njiric Niko, Mrak Goran
Department of Neurosurgery, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia.
Department of Neuropathology, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1282-1284. doi: 10.4103/ajns.AJNS_112_18.
Spinal cord lipomas are rare and benign tumors which may cause progressive neurological deficits due to their local expansion. We present the case of a 59-year-old male patient with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images of the thoracic spine suggested a subacute intramedullary hematoma. Due to progression of the neurological deficit, the patient was referred to a neurosurgeon, who indicated surgical evacuation of the hematoma. The intraoperative finding revealed an intramedullary spinal cord lipoma, which was later confirmed by histological analysis. Since subacute intramedullary hematomas and intramedullary spinal cord lipomas present with similar clinical and radiological features, diffusion-weighted MR imaging should be used to distinguish these entities.
脊髓脂肪瘤是罕见的良性肿瘤，可因其局部扩张导致进行性神经功能缺损。我们报告一例59岁男性患者，有严重腰骶部疼痛和右腿缓慢进展性轻瘫，曾被误诊为退行性脊柱疾病。胸椎的重复磁共振（MR）T1加权图像提示亚急性髓内血肿。由于神经功能缺损进展，患者被转诊至神经外科医生处，后者建议手术清除血肿。术中发现为髓内脊髓脂肪瘤，随后经组织学分析得以证实。由于亚急性髓内血肿和髓内脊髓脂肪瘤具有相似的临床和影像学特征，应使用扩散加权MR成像来区分这些病变。
