Lipoma of the cauda equina: case report and review of the literature.

Lipoma of the cauda equina is an uncommon condition, accounting for some 1% of spinal tumours. The literature is reviewed and the case is reported of a 41-year-old diabetic woman, who was seen in 1968 with a 37-year history of left foot deformity followed by left leg weakness and sensory loss resulting in a left below-knee amputation, with subsequent development of osteomyelitis and a chronic sinus, and of urinary incontinence and sensory loss in the right foot. A complete spinal block was evident below L3. Biopsy and limited removal of a portion of a lipoma of the cauda equina associated with considerable arachnoiditis was performed in 1967 and resulted in the disappearance of chronic back pain and cessation of faecal incontinence. There was partial restoration of bladder function and of perianal and left thigh sensation. This led to the patient being able to resume her household duties, and to visit friends and social functions after having been deprived of these pleasures for many years. Her condition has been well maintained since.