Thoracolumbar spinal angiolipoma demonstrating high signal on STIR imaging: a case report and review of the literature.
BACKGROUND
Angiolipomas are rare benign tumors, accounting for 0.14% to 1.2% of all tumors of the spinal axis with vascular and fatty histological features. Spinal angiolipoma (SAL) is most commonly found in the thoracic region and has high signal on contrast enhanced fat-saturated T1-weighted imaging. Although the international literature is extensive, there are few cases reported in United States.


OBJECTIVE
To present a case of SAL located in the thoracolumbar region without high signal on contrast enhanced fat-saturated T1-weighted imaging and to review previously reported cases.


METHODS
Case report and review the literature.


RESULTS
Magnetic resonance imaging obtained in a 68-year-old man with a long history of lumbago showed a heterogeneous mass (T10-L1) hyperintense on T1-weighted imaging but not enhancing on suppression fat sequences, suggesting epidural hematoma. Surgical excision of the lesion was performed, and SAL was diagnosed and confirmed by pathology. The patient became asymptomatic.


CONCLUSIONS
The predominance of either vascular or fatty components inside the tumor might alter the expected results on magnetic resonance imaging with suppression fat sequences.
Department of Neurology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA. Electronic address: reyesd@ccf.org.
Dennys
D
Reyes
Fabian J
FJ
Candocia
D000368:Aged; D018206:Angiolipoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D013125:Spinal Neoplasms / Q000473:pathology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery
MRI of the lumbar spine; Paraparesis; Paraplegia; STIR image; Spinal angiolipoma