King Kali A, Tsao Tiffany, Abdulrahim Ahmed, Hildenbrand Alec
Internal Medicine, Creighton University School of Medicine, Omaha, USA.
Pathology and Laboratory Medicine, Creighton University School of Medicine, Omaha, USA.
Cureus. 2023 Sep 15;15(9):e45305. doi: 10.7759/cureus.45305. eCollection 2023 Sep.
A spinal epidural angiolipoma is a rare, benign tumor of adipocytes and blood vessels that accounts only for a small percentage of all spinal axis tumors. We report a case of a 44-year-old male who presented with three months of progressive decreased sensation and strength from about six cm above the umbilicus down to his feet bilaterally. He presented to the emergency room when he could no longer walk. He also had neurogenic urinary retention and likely neurogenic constipation. Physical exam was notable for decreased sensation, decreased strength, and increased patellar reflexes bilaterally. MRI of the thoracic spine showed a posterior epidural mass that spanned from T2 to T3, measuring 1.2 x 1.7 x 4.3 cm, and severely compressed the spinal cord posteriorly. The patient underwent an urgent laminectomy for decompression and mass resection. Pathology was consistent with an angiolipoma. Postoperatively, he experienced a drastic improvement in strength and gross motor skills. The sensation had a partial return following surgery and continued to improve over the hospital stay. In general, the literature reports significant symptomatic improvement in patients with spinal epidural angiolipomas after surgical resection.
脊髓硬膜外血管脂肪瘤是一种罕见的由脂肪细胞和血管构成的良性肿瘤，仅占所有脊柱肿瘤的一小部分。我们报告一例44岁男性患者，其双侧自脐上约6厘米以下至足部出现进行性感觉减退和肌力下降3个月。当他无法行走时前往急诊室就诊。他还存在神经源性尿潴留及可能的神经源性便秘。体格检查发现双侧感觉减退、肌力下降以及髌反射亢进。胸椎MRI显示一个从T2至T3的硬膜外肿块，大小为1.2×1.7×4.3厘米，向后严重压迫脊髓。患者接受了紧急椎板切除术以减压并切除肿块。病理结果符合血管脂肪瘤。术后，他的肌力和总体运动技能有了显著改善。术后感觉有部分恢复，并在住院期间持续改善。总体而言，文献报道脊髓硬膜外血管脂肪瘤患者手术切除后症状有明显改善。
