Fact-sheet: Intradural lipoma


Updated on 09/20/2019 at 9:46 AM

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Definition

Rare, congenital benign tumor, belonging to the group of spinal lipomas (also including Lipoma of filum terminale and Lipomyelomeningocele) and closed dysraphisms:

  • 1% of all spinal tumors
  • Attached to the posterior (or posterolateral) surface of the spinal cord
  • Location: can be found at any level of the spinal cord. Often found at the thoracic level
  • Very slow growth potential
  • Often discovered in newborns or young children due to associated overlying dorsal cutaneous abnormalities
  • Later in adolescents or young adults, due to the onset/worsening of neurological symptoms

Clinical features

- Most often asymptomatic

- Headaches, chronic thoracolumbar back pain due to increased intradural pressure

- Lower limb pain

- Sensorimotor deficits

- Spinal cord compression

- Pregnancy and the postpartum period may worsen symptoms (due to increased intradural pressure)

Radiography

Localized widening of the spinal canal in cases of large lesions

CT

Fat-density lesion

Possible associated malformations

MRI

MRI is the imaging modality of choice:

  • Fatty lesion, hyperintense on T1
  • Hypointense on fat-saturated sequences
  • Intradural, extramedullary lesion
  • No enhancement after gadolinium injection

Management

Surgical resection (often partial - narrow margins with the spinal cord)

Differential diagnosis

Other intradural extramedullary tumors