Intramedullary spinal cord lipoma mimicking a late subacute hematoma

Pašalić, Ivan and Brgić, Klara and Nemir, Jakob and Kolenc, Danijela and Njirić, Niko and Mrak, Goran (2018) Intramedullary spinal cord lipoma mimicking a late subacute hematoma. Asian Journal of Neurosurgery, 13 (4). pp. 1282-1284. ISSN 1793-5482

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Abstract

Spinal cord lipomas are rare and benign tumors which may cause progressive neurological deficits due to their local expansion. We present the case of a 59-year-old male patient with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images of the thoracic spine suggested a subacute intramedullary hematoma. Due to progression of the neurological deficit, the patient was referred to a neurosurgeon, who indicated surgical evacuation of the hematoma. The intraoperative finding revealed an intramedullary spinal cord lipoma, which was later confirmed by histological analysis. Since subacute intramedullary hematomas and intramedullary spinal cord lipomas present with similar clinical and radiological features, diffusion-weighted MR imaging should be used to distinguish these entities.

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