J Korean Neurosurg Soc.  2022 Jan;65(1):49-56. 10.3340/jkns.2021.0005.

Spinal Angiolipomas : Clinical Characteristics, Surgical Strategies and Prognosis

• Zhang X
• Dong S
• Wang G
• Zhang H
• Wang JJ
• Wang G

• KMID: 2523913
• DOI: http://doi.org/10.3340/jkns.2021.0005

Abstract

Objective
: Angiolipomas are usually found in the subcutaneous tissue of the trunk and limbs. Spinal angiolipomas (SALs) are uncommon and have rarely been reported. We report a series of nine SALs patients who received surgical treatment in our department. To summarize the clinical characteristics of SALs, propose our surgical strategies, and evaluate the effects of the operation.
Methods
: This was a retrospective review of nine SALs patients who received surgical treatment from August 2015 to March 2020. Total or subtotal resection was determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. The outcomes were assessed based on the modified Japanese Orthopaedic Association (mJOA) scoring system utilized before surgery and at various follow-up points.
Results
: Among the nine patients, the mean mJOA score before surgery was 6.6±2.3, compared with 10.1±1.1 at the last follow-up time point (33.4±11.8 months). All patients achieved good outcomes, even in cases of subtotal resection.
Conclusion
: Early surgical resection of SALs is recommended, and the specific procedures should be determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. Most of the patients had a good prognosis, even in cases of subtotal resection.

Keyword

Angiolipoma, spine; Diagnosis; Surgery; Prognosis

Figure

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  Fig. 1. A-D : It presents the magnetic resonance imaging (MRI) scans of patient No. 4. The dorsally located epidural mass (T11–T12) was isointense on T1-weighted images (WI), hyperintense on T2WI, and homogeneously enhanced on contrast-enhanced images. E-H : It presents the MRI scans of patient No. 1. The mass was located in the ventral part, and the vertebral body (L5) and right intervertebral foramen were also affected. The mass and the affected vertebral body were hypointense on T1WI, hyperintense on T2WI, and inhomogeneously enhanced on contrast-enhanced images. A and E : Sagittal T1WI. B and F : Sagittal T2WI. C and G : Sagittal contrast-enhanced image. D and H : Axial contrast-enhanced image.

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  Fig. 2. A and B : It presents the postoperative the magnetic resonance imaging (MRI) scans (2 years after surgery) of patient No. 4. MRI shows that the tumors were completely removed without recurrence. C-F : It presents the postoperative MRI (1 month and 4 years after surgery) scans of patient No. 1. The results show that the tumors were partially removed, and there was no sign of further growth. A : Sagittal T2WI. B : Axial T2WI. C : Sagittal T2WI 1 month after surgery. D : Axial T2WI 1 month after surgery. E : Sagittal T2WI 4 years after surgery. F : Axial T2WI 4 years after surgery.

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  Fig. 3. A : Intraoperative photo. The tumors were mainly composed of adipose tissue mixed with vascular structures that easily bled. B : Photomicrograph. The tumor was composed of mature adipose tissue and proliferating vascular elements (H&E, original magnification ×40).

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