Lipoma of the conus

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Numbness and urinary symptoms.

Patient Data

Age: 25 years
Gender: Female
mri

There is an 8 x 12 x 14 mm well-defined high signal (on T1/2) intradural intramedullary mass lesion involving the conus medullas that loses signal in STIR images consisting of fat component.

mri

After contrast injection, the conus medullaris fat equivalent signal mass shows internal septal enhancement.

Case Discussion

The appearances are in keeping with a conus medullaris lipoma. There are few fat-containing intradural lesions including lipoma and dermoid cyst. The presence of a solid enhancing component makes the diagnosis dermoid almost certainly and excludes a simple lipoma.

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