Symptomatic spinal epidural lipomatosis associated with Cushing's syndrome

In cases of Cushing's syndrome, unusual amounts of fat may accumulate in the spinal epidural space, similar to centripetal fat deposits elsewhere in the body. The mass of excessive epidural fat may be responsible for neurological symptoms referable to compression of the spinal cord or cauda equina. We report three cases illustrating this unusual phenomenon and call attention to three cases reported previously. Although it is an unusual complication of Cushing's syndrome, epidural lipomatosis should be considered in the differential diagnosis of any such case with neurological symptoms referable to the spinal cord or cauda equina. The diagnosis may be confirmed by computed tomographic scanning in conjunction with myelography. Therapeutic considerations are discussed.