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Thoracic Spinal Angiolipomas: A Systematic Review.

Giuseppe Emmanuele Umana1, Massimiliano Visocchi2,3, Elena Roca4

  • 1Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy.

Journal of Neurological Surgery. Part A, Central European Neurosurgery
|December 20, 2021
PubMed
Summary

Spinal angiolipomas (SAs) are rare, benign tumors. Surgical resection offers a favorable outcome with no recurrence, making gross total removal the standard treatment.

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Area of Science:

  • Neurosurgery
  • Oncology
  • Radiology

Background:

  • Spinal angiolipomas (SAs) are rare, benign tumors, typically found in the extradural posterior thoracic region.
  • These tumors can exhibit multimetameric extension, posing unique diagnostic and treatment challenges.

Purpose of the Study:

  • To systematically review the literature on spinal angiolipomas (SAs).
  • To analyze the characteristics, treatment, and outcomes of SA patients.
  • To report three emblematic cases of SA surgical resection.

Main Methods:

  • A systematic literature review was conducted using PubMed and Scopus databases, adhering to PRISMA guidelines.
  • Search terms included "spinal angiolipoma" and related keywords, with a restriction to English-language articles.
  • Three patient cases undergoing surgical resection of spindle-shaped (type IA) and dumbbell-shaped (type II) SAs between 2014 and 2020 were included.

Main Results:

  • A total of 60 patients (36 female, 24 male; mean age 53.12 years) were analyzed from 33 studies and 3 reported cases.
  • The most common location was the T5 level, with extradural, spindle-shaped type IA SAs being predominant (88.3%).
  • Gross total removal (GTR) was achieved in 93.3% of patients, with 85% experiencing full motor deficit recovery and no recurrence observed at follow-up.

Conclusions:

  • Spinal angiolipomas (SAs) are rare, benign tumors with a significant vascular component and favorable prognosis.
  • Gross total removal (GTR) is the gold standard treatment, often without the need for adjuvant therapy.
  • Differentiated surgical techniques are crucial for dumbbell-shaped SAs to manage bleeding and achieve successful en bloc resection.