J Korean Med Sci.  2006 Dec;21(6):1133-1135. 10.3346/jkms.2006.21.6.1133.

Tethered Spinal Cord with Double Spinal Lipomas

• Kim MJ
• Yoon SH
• Cho KH
• Won GS

• KMID: 1713135
• DOI: http://doi.org/10.3346/jkms.2006.21.6.1133

Abstract

Although lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients, and 66% of lipomyelomeningoceles in young patients are accompanied by hypertrophic filum terminale, it is very rare to find two isolated spinal lipomas simultaneously. A 3 month-old baby girl was admitted to the hospital for a protruding, non-tender, soft, subcutaneous 2.5 cm mass of the lumbosacral area that had been present since birth. Simple radiography showed a spinal posterior arch defect from L3 to L5, and magnetic resonance imaging (MRI) demonstrated two isolated spinal lipomas, a transitional type from L3 to L5, and a terminal type below S1 without dural defect. The cornus medullaris was severely tethered descending to the S1, but there was no cerebellar or brain stem herniation on the MRI. We suggest that the presence of a combined spinal lipoma should be a point for careful differentiation in an infant with spinal lipoma.

Keyword

Lipoma; Spinal Dysraphism; Tethered Cord Syndrome; Neural Tube Defects

MeSH Terms

Treatment Outcome
Spinal Cord Neoplasms/*diagnosis/*surgery
Neural Tube Defects/*diagnosis/*surgery
Lumbosacral Region/*surgery
Lipoma/*diagnosis/*surgery
Infant
Humans
Female

Figure

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  Fig. 1 Initial preoperative spine MR of T1-weighted (A) and T2-weighted images (B) shows tethered cornus medullaris to the level of sacrum and two isolated lipomyelomeningoceles, a transitional type from L3 to L5 (arrows), and a terminal type below S1 (arrow heads).

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  Fig. 2 (A) After incision of the dura of L2 to S1, the normal cord (arrows) and transitional type spinal lipoma (arrow heads) are exposed. (B) Another terminal type spinal lipoma (arrow heads) was exposed and removed from the filum terminale (black arrow) after upper transitional type spinal lipoma was detethered and dissected (white arrows).

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