Lipoma of filum terminale

Case contributed by Dr Aneta Kecler-Pietrzyk

Presentation

50 year old lady with chronic lower spine pain. Background: diabetes

Patient Data

Age: 50
Gender: Female
MRI

Linear T1 hyper intense and T2 hypo intense  intradural focus extending from L3 - S1 representing lipoma of filum terminale.

In most cases lipoma of filum terminale is incidental finding, however association with tethered cord syndrome is described in literature. 

Disc bulge at the level of L3/L4, L4/L5 causing mild foraminal narrowing bilaterally. 

Case Discussion

Lipoma of filum terminale is a consequence of mesodermal cells migration error during embyogenesis.

As any adipose lesion it is best seen on T1 sequences.

In most cases lipoma of filum terminale is incidental finding of no clinical significance, however association with tethered cord syndrome is described in literature.

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