title: Percutaneous Endoscopic Removal of a Lumbar Epidural Angiolipoma via Interlaminar Approach: A Technical Report.
abstract: BACKGROUND
  Although percutaneous endoscopic technique has been routinely used in the treatment of disk herniation, there are few reports on its application in the management of intraspinal tumors. We present a case report of lumbar epidural angiolipoma that was totally removed by percutaneous endoscopic technique.
  
  
  METHODS
  A 63-year-old man presented with a 4-month history of progressively worsening low back pain. No abnormal neurologic finding was noted on physical examination, and magnetic resonance imaging demonstrated a dorsally located L2-3 epidural lesion, suggestive of a noninfiltrating angiolipoma. During the operation, an 8-mm skin incision was made, and a dilator was bluntly inserted toward the interlaminar space, followed by insertion of a working cannula onto the ligamentum flavum and placement of the endoscope. The interlaminar space was enlarged by resection of part of the lower rim of the right L2 vertebral laminae, and the right side of the interlaminar ligamentum flavum was removed to expose the tumor. The tumor was totally removed piecemeal under endoscopic guidance, and pathologic examination confirmed the diagnosis of angiolipoma.
  
  
  CONCLUSIONS
  This report supports the application of percutaneous endoscopic technique in the surgical resection of noninfiltrating extradural lumbar angiolipoma.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Ying
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Neurosurgery, Ningbo No. 2 Hospital, Ningbo, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Ren
authors.affiliation: Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, China. Electronic address: 96015@cch.org.tw.
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Electronic address: neurosurgery@zju.edu.cn.
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Zhu
mesh_terms: D018206:Angiolipoma / Q000473:pathology / Q000601:surgery*; D015174:Epidural Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D044583:Neuroendoscopy / Q000379:methods*; D016896:Treatment Outcome
keywords: Angiolipoma; Interlaminar approach; Lumbar spine; Percutaneous endoscope