Tethered spinal cord with double spinal lipomas.

Area of Science:

• Pediatric Neurosurgery
• Spinal Dysraphism
• Medical Imaging

Background:

• Lumbosacral lipoma is a rare congenital condition.
• Lipomyelomeningocele often involves a hypertrophic filum terminale.
• Simultaneous occurrence of two isolated spinal lipomas is exceptionally rare.

Observation:

• A 3-month-old infant presented with a congenital lumbosacral subcutaneous mass.
• Radiography revealed a posterior spinal arch defect (L3-L5).
• MRI identified two distinct spinal lipomas: a transitional type (L3-L5) and a terminal type (below S1).

Findings:

• The infant had a transitional and a terminal spinal lipoma without dural defect.
• Severe tethering of the conus medullaris to S1 was observed.
• No cerebellar or brainstem herniation was detected.

Implications:

• The case underscores the rarity of combined spinal lipomas.
• Careful diagnostic differentiation is crucial for infants with spinal lipomas.
• This presentation emphasizes the need for comprehensive imaging and evaluation.