Epidural angiolipoma

Case contributed by Frank Gaillard


Minor back pain for investigation.

Patient Data

Age: 60 years
Gender: Female

An extradural mass dorsal to the theca and cord extends from T2-T6, anteriorly displacing and moderately compressing the spinal cord, heterogeneous but predominantly T1 hyperintense, T2 hyperintense, and vividly contrast enhancing (best shown on the sagittal fat-saturated post contrast images). The lesion extends into the exit foramen at both T4/5 and T5/6, but no direct involvement of bone is shown and no bony destruction. The overall extent of the lesion has not altered.

Although there is complete effacement of CSF at the central component of the tumor, the cord demonstrates normal signal intensity.


The patient went on to have a laminectomy and resection of the mass. 


The sections show features of angiolipoma in each of the nine specimens submitted. Each specimen shows thin-walled vascular channels of varying caliber lined by unremarkable endothelial cells, These are haphazardly dispersed within mature adipose tissue. Foci of non-specific chronic inflammation are also noted.  There is no evidence of malignancy in any of the specimens submitted. 

DIAGNOSIS: angiolipoma

Case Discussion

The lesion in the epidural space at the dorsal theca causing cord compression contains fat and also demonstrates prominent contrast enhancement in a middle-aged female are very characteristic of an epidural angiolipoma, with no other differential being a realistic possibility. This was subsequently proven histologically. 

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