PMC8114595_01
(a) Sagittal and (b) axial pre-operative T1-weighted spinal MRI demonstrating the intramedullary lipoma. (c) Intra-operative view after dural opening showing the yellowish lipoma (arrow) causing diffuse swelling of the spinal cord and bulging from the opening. (d) The internal part of the lipoma resected
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Thoracic spine magnetic resonance imaging (MRI) revealed an intramedullary mass lesion seen at the level of T1-T6, which was hyper-intense on both T1 and T2-weighted images, with slight signal suppression on fat suppression sequences (Figure 1a and b). The intramedullary yellowish fatty and highly-vascularized mass was compressing the spinal cord internally and bulged extensively as the myelotomy was performed (Figure 1c). There was no definite cleavage between the tumor and spinal cord. The outer part was very adherent to the spinal cord, thus it was left in place (Figure 1d).
(a) Sagittal and (b) axial post-operative T1-weighted spinal MRI after 2 months demonstrating the reduced volume of the tumor and internal debulking. (c) A Photomicrograph shows mature adipose tissue separated by thin fibrous bands. No neuronal tissue was identified (X100 hematoxylin and eosin)
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Post-operative MRI showed significant internal debulging of the tumor with rim-like remnants in the outer part of the tumor cavity (Figure 2a and b). A histopathologic examination revealed mature adipocytes with fibrous tissue and few vascular channels with no signs of malignancy, with final diagnosis of lipoma (Figure 2c).