Intradural lipoma

Case contributed by A.Prof Frank Gaillard

Presentation

CT chest and thoracic spine for trauma assessment (fall 3m).

Patient Data

Age: 45 years
Gender: Male
Modality: CT

Sagittal bone and axial soft tissue images demonstrate a mass with fat density posterior to the cord, appearing extramedullary but intradural. 

The T8 vertebral body has a subtle cortical contour abnormality. 

Modality: Annotated image

Sagittal bone and axial soft tissue images demonstrate a mass with fat density posterior to the cord (yellow arrow),  appearing extramedullary but intradural. 

The T8 vertebral body has a subtle cortical contour abnormality (red arrow), which in this clinical setting is suspicious for a compression fracture. 

The patient went on to have an MRI to both further assess the questionable fracture and to assess the fatty mass. 

Modality: MRI

MRI demonstrates an elliptical intradural extramedullary fairly homogenous fat-containing lesion on the posterior aspect of cord, compressing and displacing the cord anteriorly. Tiny internal nodules are seen, with equivocal enhancement in few of them. No extradural extension. 9 x 4mm (axial). Rim chemical shift artefact.

Bone marrow oedema is confirmed in T8 as well as T5 consistent with compression fractures. 

Modality: Annotated image

A spindle shaped intradural extramedullary mass (yellow arrows) is located posterior to the cord. The mass follows fat on all sequences, including T2 STIR and T1 fat saturated sequences (orange arrows) confirming it is made of fat. On sagittal T2 images a prominent chemical shift artefact is also visible (white line behind the mass (green arrow), black line infront of the mass (blue arrow)). 

Bone marrow oedema is seen involving T5 and T8 (red arrows). 

Case Discussion

This case illustrates typical appearances of an incidental spinal cord lipoma, with associated compression fractures. 

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Case Information

rID: 19297
Case created: 24th Aug 2012
Last edited: 5th Nov 2015
Tag: spine
Inclusion in quiz mode: Included

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