Acute paraplegia due to an extradural spinal lipoma: case report

We describe a 20 year old man, who presented with an acute onset of transverse myelopathy evolving over 24 h at T6 spinal level; as yet, an unreported presenting symptom from a midthoracic intraspinal lipoma. The C.S.F. findings suggested a spinal block. MRI, imaging was not practical. Urgent myelography revealed extradural compression at the T5-6 vertebral level. The patient underwent surgical debulking of the tumor which on histopathology was found to be a lipoma, but there was no neurological improvement even at 3 months follow up. We believe that patients with intraspinal lipomas are at high risk of developing irreversible neurological dysfunction.