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Spinal angiolipomas. Report of three cases
M C Preul1, R Leblanc, D Tampieri
1Division of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada.
Journal of Neurosurgery
|February 1, 1993
Summary
Spinal angiolipomas, benign tumors of lipocytes and blood vessels, predominantly affect women and cause spinal compression. Magnetic resonance imaging (MRI) is key for diagnosis, with surgery offering successful symptom relief.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Spinal angiolipomas are rare, benign tumors comprising mature lipocytes and abnormal blood vessels.
- Understanding their demographics, clinical presentation, and diagnostic characteristics is crucial for effective management.
Observation:
- A study of 37 spinal angiolipoma cases (23 female, 14 male) revealed a mean age of 43 years, with females being older on average.
- Symptoms included lower extremity weakness (97%), sensory dysfunction (94%), hyperreflexia/spasticity (84%), sphincter dysfunction (51%), and back pain (41%).
- Lesions were predominantly extradural (35/37), often in the midthoracic region (53%), and occasionally infiltrated bone (7/37).
Findings:
- Pregnancy (22% of female patients) and weight gain exacerbated symptoms, suggesting hormonal and vascular influences.
- Plain radiographs were abnormal in 39% of cases, myelograms in 97%, and both CT and MR imaging identified lesions, with MR being optimal.
- Vascular enhancement was noted with contrast-enhanced CT and MR imaging.
Implications:
- Spinal angiolipomas primarily affect women, particularly peri- or postmenopausal individuals, and can cause significant spinal cord compression.
- Hormonal factors and vascular engorgement may play a role in their development and symptom exacerbation.
- Magnetic resonance imaging (MRI) is the diagnostic modality of choice, and surgical resection provides excellent outcomes.