Sandeep Mohindra1, Sunil Kumar Gupta. 1. Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sandeepmohindra@gmail.com
Abstract
BACKGROUND CONTEXT: Spinal lipomas not associated with spinal dysraphism are rare entities. Further, large medullary lipomas with intracranial extension are occasionally described. Most of the intradural lipomas are subpial and not really intramedullary. PURPOSE: Clinicians may be made aware of such a rare entity and its presentation. STUDY DESIGN/ SETTING: An extremely rare case of medullary lipoma extending into posterior fossa is described in an adult, not associated with spinal dysraphism. METHODS: A young male presented with high cord myelopathy in the form of spastic quadriparesis. Radiological investigations revealed dorsally placed intramedullary lipoma extending into posterior fossa. RESULTS: Surgical excision of tumor provided satisfactory resolution of symptoms. CONCLUSIONS: Medullary lipomas may present with features of high cord compression and myelopathy. Magnetic resonance imaging remains the investigative and follow-up modality of choice. Even when total tumor excision is not feasible, subtotal removal and decompression provides long lasting symptom-free survival.
BACKGROUND CONTEXT: Spinal lipomas not associated with spinal dysraphism are rare entities. Further, large medullary lipomas with intracranial extension are occasionally described. Most of the intradural lipomas are subpial and not really intramedullary. PURPOSE: Clinicians may be made aware of such a rare entity and its presentation. STUDY DESIGN/ SETTING: An extremely rare case of medullary lipoma extending into posterior fossa is described in an adult, not associated with spinal dysraphism. METHODS: A young male presented with high cord myelopathy in the form of spastic quadriparesis. Radiological investigations revealed dorsally placed intramedullary lipoma extending into posterior fossa. RESULTS: Surgical excision of tumor provided satisfactory resolution of symptoms. CONCLUSIONS: Medullary lipomas may present with features of high cord compression and myelopathy. Magnetic resonance imaging remains the investigative and follow-up modality of choice. Even when total tumor excision is not feasible, subtotal removal and decompression provides long lasting symptom-free survival.