A case of thoracic epidural angiolipoma: CT and MRI findings

Spinal angiolipomas are rare benign tumors composed of mature adipose cells and blood vessel walls. We report the case of a patient with a spinal epidural angiolipoma who presented with paraplegia and was treated by urgent tumor resection and decompression. The patient was a 79-year-old man who presented to our hospital with a 6-month history of numbness in both lower limbs. Plain CT showed a tumor-like lesion with a predominantly fatty component on the dorsal epidural surface at the Th2-4 level, and contrast-enhanced CT showed a relatively strongly heterogeneously enhancing lesion. Gadolinium (Gd) -enhanced MRI also showed a well-defined spindle-shaped lesion measuring 2.4 × 1.0 × 6.5 cm in size that was visualized as a heterogeneous high signal intensity on both T1- and T2-weighted images and showed strong heterogeneous enhancement on fat-saturated Gd-enhanced T1-weighted images. We performed Th1-4 laminectomy and tumor resection and the patient was discharged home, with no numbness in the lower limbs.