Yamai Yuki, Nagoshi Narihito, Kawaida Miho, Suzuki Satoshi, Takahashi Yohei, Nori Satoshi, Osahiko Tsuji, Yagi Mitsuru, Watanabe Kota, Matsumoto Morio, Nakamura Masaya
Department of Orthopaedic Surgery, Keio University Hospital, Shinjuku, Tokyo, Japan.
Department of Orthopaedic Surgery, Keio University Hospital, Shinjuku, Tokyo, Japan
BMJ Case Rep. 2025 Jun 22;18(6):e263228. doi: 10.1136/bcr-2024-263228.
Angiolipomas in the lumbar spine are rare, with only a few reported cases presenting in a dumbbell shape. We report a case of a dumbbell-shaped lumbar angiolipoma extending not only into the spinal canal and the intervertebral foramen but also extensively into the iliopsoas muscle. A male patient in his early 60s, presenting with an 8-month history of low back pain and bilateral lower extremity pain, was referred to our department for treatment. MRI revealed a large dumbbell-shaped tumour located around the L2/3 spinal canal and extending into the left iliopsoas muscle. Angiolipoma was suspected, and preoperative embolisation followed by surgery using both anterior and posterior approaches was performed. Complete resection was achieved, and the patient's pain significantly improved without major postoperative complications. This surgical procedure may be considered an effective approach for the resection of dumbbell-shaped angiolipomas with extensive extraforaminal distribution.
腰椎血管脂肪瘤较为罕见,仅有少数报道的病例呈哑铃状。我们报告一例哑铃状腰椎血管脂肪瘤,该肿瘤不仅延伸至椎管和椎间孔,还广泛侵入髂腰肌。一名60岁出头的男性患者,有8个月的腰痛和双侧下肢疼痛病史,被转诊至我科治疗。磁共振成像(MRI)显示一个大型哑铃状肿瘤位于L2/3椎管周围,并延伸至左侧髂腰肌。怀疑为血管脂肪瘤,遂先进行术前栓塞,然后采用前后联合入路进行手术。手术实现了完整切除,患者疼痛明显改善,且无重大术后并发症。对于切除具有广泛椎间孔外分布的哑铃状血管脂肪瘤,该手术方法可被视为一种有效的途径。