A 24-year-old man presented with a 6-month history of weakness of the right lower limb, without upper extremity weakness. Spinal cord CT/MRI showed an extensive intramedullary lesion from C7 to T4, with classical radiologic features of lipoma (Figure). There was no spinal dysraphism. Subtotal resection of the lesion was performed. The pathology confirmed the diagnosis of lipoma. Postoperatively, the patient's motor function temporarily deteriorated. The symptoms improved after 2-month rehabilitation. Nondysraphic spinal intramedullary lipomas are extremely rare, constituting approximately <1% of all intraspinal tumors.1,2 MRI is the most sensitive imaging protocol; typical radiologic appearances can confirm diagnosis and avoid biopsy.
(A–C) T1-weighted, fat-suppressed T2-weighted, and T2-weighted images showed an intramedullary homogeneous lesion extending from C7 to T4. (D) Postcontrast T1-weighted imaging showed no enhancement. (E) CT showed a fatty lesion (–131 HU). (F) Lipoma was consisted of mature adipocytes (H&E: 200×). (G and H) After the subtotal resection, MRI showed the residual lesion.
Study Funding
No targeted funding reported.
Disclosure
The authors report no relevant disclosures. Go to Neurology.org/N for full disclosures.
Acknowledgment
We all express our gratitude to the patient, who kindly gave consent for publishing this paper.
Appendix Authors
Footnotes
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Submitted and externally peer reviewed. The handling editor was Roy Strowd III, MD, Med, MS.
- Received March 5, 2022.
- Accepted in final form July 11, 2022.
- Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
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