Non-dysraphic intradural spinal cord lipoma: case series, literature review and guidelines for management.
OBJECTIVE
Non-dysraphic intradural spinal cord lipomas are rare lesions and the management remains controversial. We present our experience with five cases and propose guidelines for their management.


METHODS
Five patients who underwent surgery for non-dysraphic spinal cord lipomas between January 2004 and April 2009 were retrospectively reviewed. All had varying degrees of neurological symptoms at the time of surgery with characteristic features on magnetic resonance imaging (MRI). All patients underwent decompression with a laminectomy/laminoplasty and debulking. The dura was primarily closed in one patient. The literature was also extensively reviewed regarding these rare lesions and optimum management guidelines proposed.


RESULTS
The age at presentation ranged from 17 to 52 years (mean 32.2). Minimum follow-up was 8 months and maximum follow-up was 5 years. There was neurological improvement following surgery in all cases. Post-operative MRI scan showed evidence of significant residual tumour in all patients.


CONCLUSIONS
The extent of surgical resection does not necessarily correlate with clinical outcome. The aim of surgery should, therefore, be adequate decompression with preservation of neural structures. Aggressive debulking should be avoided. Onset of any neurological symptoms/signs, bowel or bladder symptoms or intractable local symptoms should be an indication for surgery.
Kabir
Syed Mohammed Rezaul
SM
The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. rezaulkabir@hotmail.com
Thompson
Dominic
D
Rezajooi
Kia
K
Casey
Adrian T H
AT
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008067:Lipoma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult