Spinal angiolipoma

Background: Spinal epidural angiolipoma is a rare cause of spinal cord comp ression. We present a case and review the clinical presentation, radiologic al appearance, pathological aspects and treatment of this distinct clinico- pathological entity. Methods: A case of a 46-year-old woman with a five-mon th history of progressive myelopathy affecting her lower extremities is pre sented. CT and MRI revealed a large epidural fat-containing mass compressin g the spinal cord dorsally at the T7-T8 level. A laminectomy was performed with gross total resection of the lesion. Results: The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has reveale d no signs of tumor recurrence and no neurological deficit. Conclusion: The diagnosis of spinal angiolipoma should be considered in the differential d iagnosis of spinal cord compression. Magnetic resonance imaging is the inve stigation of choice. The surgical objective is complete excision but, for a nterior lesions involving bone, an overly aggressive approach should be tem pered by an awareness of the overall indolent natural history of so-called "infiltrating" spinal angiolipomas that are only partially excised.