Thoracic epidural lipomatosis associated with syrinx: A case report

Epidural lipomatosis with associated syrinx formation is an exceedingly rare clinical entity. In this case report we present a 48-year old female who initially presented with symptoms of progressive myelopathy and later developed urinary incontinence. Her imaging studies showed upper thoracic epidural lipomatosis and associated spinal stenosis, cord compression and a mildly expansile right paracentral syrinx at C7-T1. She underwent a decompression surgery which provided her with partial symptomatic relief. On MRI, there was a mild decrease in the size of syrinx and some improvement in the degree of spinal stenosis. However, the subsequent clinical improvement supported the possibility that spinal compression caused by epidural lipomatosis could have resulted in syrinx formation. Therefore, such cases can be appropriately treated with spinal decompression surgeries or syrinx shunting procedures.