[Own experience in surgical treatment of intramedullary spinal cord lipomas]

The aim of this report is to present own experiences in surgical treatment of extremely rare occurring intramedullary spinal cord lipomas without spinal dysraphism. Our experience with such tumours based on 2 cases out of 15 intramedullary spinal cord tumours that were treated at our department from 1984 to 1997. The tumours were located at C4-C7 and C6-Th6 spinal cord region. The patients were 16-year-old woman and 57-year-old woman. Both patients presented with long history of progressive spinal cord damage with rapid deterioration after mild injury. The diagnosis was based on myelography in one case and on MRI in the second one. In first case the tumour was totally removed and we achieved neurological improvement. In the second case the tumour was subtotally removed and after 12 months on MR examination we found relapse of the tumour without neurological deterioration. We found two types of the tumours. The first one was well separated from the normal spinal cord and easy to remove. In the second it closely adhered to the spinal cord without possibility of total excision. The surgical treatment of intramedullary spinal cord lipomas is very difficult and dangerous but only in this way we can protect the patients from total paralysis and to improve their comfort of the life.