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