Key Clinical Findings & Highlights
- Explains radiological fat-suppression MRI features diagnostic of angiolipoma.
- Details bloodless en-bloc extradural excision technique.
- Reports full reversal of lower-limb spastic paraparesis.
Abstract
Introduction & Background
Spinal angiolipomas are categorized into non-infiltrating and infiltrating subtypes. The vast majority are non-infiltrating encapsulated extradural lesions that present with progressive myelopathy due to gradual thoracic cord or cauda equina compression.
Clinical Case Presentation & Diagnosis
A 52-year-old female presented with progressive weakness in both lower limbs, gait instability, and band-like thoracic numbness over 5 months. Spine MRI revealed an elongated, well-defined extradural mass at the T11-L1 level exhibiting hyperintense signal on both T1- and T2-weighted sequences with marked heterogeneous enhancement on fat-suppressed contrast images.
Surgical Technique & Management
A standard posterior midline approach with T11-L1 laminectomy was performed. A highly vascular, yellowish-red encapsulated extradural mass was found compressing the dorsal thecal sac. Microsurgical coagulation of arterial feeders and en-bloc tumor excision were achieved without entering the dura mater.
Discussion & Literature Context
The high fat content combined with hypervascularity produces characteristic MRI signal signatures. Surgical excision carries an exceptional prognosis with negligible recurrence rates for non-infiltrating variants.
Conclusion
Complete surgical resection of spinal angiolipoma reliably leads to complete neurological restoration even in patients with profound preoperative myelopathy.
How to Cite This Research
Dr. Surendra K. Gupta, A. Chhabra, H. K. Prajapati, F. Ahmad (2020). "Dorsolumbar angiolipoma: A rare case report and review of literature". Romanian Neurosurgery, Volume 34, Issue 4, Pages 540-543.
