[An adult case of lumbar intradural lipoma]

A 42-year-old female with intradural lipoma at the level of L1 is reported. She was admitted with a history of 32 months of lumbago, 25 months of pain of the left leg, and 12 months of motor weakness in the left leg. Neurologically, sensory impairment below the L1 dermatome of the left leg, and motor weakness of bilateral legs were noted on admission. CT demonstrated a low density mass with no contrast enhanced effect at the level of L1. MRI showed a mass with high signal intensity on the T1-weighted image, and low signal intensity on the T2. L1 laminectomy, and additional Th12 and L2 partial laminectomy were performed and the tumor was partially removed. The tumor was completely in the intradural space. Pathologically, the tumor consisted of mature adipose cells with normal vessels. Postoperatively, the epidural effusion at the operative area caused sensory impairment and motor weakness of the right leg. Finally, the patient came to be neurologically free of defects except for slight sensory diminution of the L4 dermatome of the left leg. In this case, total removal of the tumor was difficult because of adhesion between the tumor, the cauda equina and the conus medullaris. Postoperatively, neurological findings showed a marked improvement. The preoperative neurological deterioration in this case seemed to be associated with simple compression exerted on the nerves.