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October 18, 2022; 99 (16) Resident & Fellow SectionOpen Access

Teaching NeuroImage: Lower Limb Muscle Weakness Due to Intramedullary Spinal Cord Lipoma

Haijuan Lv, Hongwei Zhao, Yu Cai
First published August 26, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201167
Haijuan Lv
From the Department of Radiology (H.L., H.Z.), the Second Affiliated Hospital of Jiaxing University, Jiaxing City, China; and Department of Diagnostic and Interventional Radiology (C.Y.), University of Texas Health Science Center at Houston, TX.
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Hongwei Zhao
From the Department of Radiology (H.L., H.Z.), the Second Affiliated Hospital of Jiaxing University, Jiaxing City, China; and Department of Diagnostic and Interventional Radiology (C.Y.), University of Texas Health Science Center at Houston, TX.
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Yu Cai
From the Department of Radiology (H.L., H.Z.), the Second Affiliated Hospital of Jiaxing University, Jiaxing City, China; and Department of Diagnostic and Interventional Radiology (C.Y.), University of Texas Health Science Center at Houston, TX.
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Teaching NeuroImage: Lower Limb Muscle Weakness Due to Intramedullary Spinal Cord Lipoma
Haijuan Lv, Hongwei Zhao, Yu Cai
Neurology Oct 2022, 99 (16) 724-725; DOI: 10.1212/WNL.0000000000201167

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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.

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Figure Pre- and Postoperative Imaging of Intramedullary Spinal Cord Lipoma

(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.

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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.

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  • Go to Neurology.org/N for full disclosures.

  • 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.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

References

  1. 1.↵
    1. Srinivasan US,
    2. Raghunathan N,
    3. Radhi L
    . Long term outcome of non-dysraphic intramedullary spinal cord lipomas in adults: case series and review. Asian Spine J. 2014;8(4):476-483.
    OpenUrl
  2. 2.↵
    1. Meher SK,
    2. Tripathy LN,
    3. Jain H,
    4. Basu S
    . Nondysraphic cervicomedullary intramedullary lipoma. J Craniovertebr Junction Spine. 2017;8(3):271-274.
    OpenUrl

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