Case contributed by Dr Ian Bickle


Fatty lump base of the back.

Patient Data

Age: 4 months
Gender: Female

Posterior elements absent from L4/L5 level.

The conus is low lying at L4/L5 with a 3.7 cm fatty intrathecal mass on the dorsal aspect contiguous with the bony dysraphic defect and in continuity with subcutaneous and extra-canalicular fat. The placode-lipoma interface is within the spinal canal.

The filum terminale lies in the midline immediately anterior and in continuity with the fatty mass.

Normal renal configuration.

Case Discussion

Newborn child with swelling over the sacrum prompting MRI to evaluate for any underlying spinal dysraphism.

There are multiple closed spinal dysraphism with associated fatty masses. Lipomas with dural defects can be broadly split into lipomyeloceles and lipomyelomeningoceles. The lipoma-placode interface is within the spinal canal and this is therefore a lipomyelocele.

The placode-lipoma interface of the fatty mass lies within the spinal canal, hence this is a lipomyelocele rather than a lipomyelomeningocele.

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Case information

rID: 52708
Published: 13th May 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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