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Thoracic Intramedullary Lipoma in a 3-year-old Child: Spontaneous Decrease in the Size Following Incomplete

Cem Yilmaz¹, Fatih Aydemir²

¹Department of Neurosurgery, Faculty of Medicine, Ankara Practice and Research Center, Baskent University, Ankara, Turkey.

Asian Journal of Neurosurgery

|March 2, 2018

Summary

Nondysraphic intramedullary spinal cord lipomas are rare. This case shows a thoracic lipoma that significantly decreased in size after surgery and continued to shrink over three years.

Keywords:

Intramedullary lipoma spontaneous decrease

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Area of Science:

Neurosurgery
Pediatric Neurology
Spinal Cord Pathology

Background:

Nondysraphic intramedullary spinal cord lipomas are exceptionally rare neurological conditions.
This report focuses on a unique case of a thoracic intramedullary lipoma in a pediatric patient.

Observation:

A 3-year-old girl presented with chronic back pain and progressive gait disturbance.
Magnetic resonance imaging (MRI) identified a T8-T9 intramedullary mass with characteristic T1 and T2 signal intensities.
The mass was surgically debulked via T8-T9 laminoplasty, with histological confirmation of mature adipose tissue consistent with lipoma.

Findings:

Post-operative MRI at one month showed a significant reduction in tumor volume (approximately 50%).
Follow-up MRIs at two and three years revealed continued spontaneous decrease in lipoma size, reaching half of the post-operative volume.
The patient developed mild kyphosis over the follow-up period.

Implications:

Surgical decompression and debulking are recommended treatments for symptomatic intramedullary lipomas.
Dietary modifications, including fat intake control, and long-term monitoring are suggested adjuncts to surgical management.
The spontaneous, long-term regression of this intramedullary lipoma offers new insights into its potential natural history and management.