engleski

Intramedullary lipoma of cervicothoracic spinal cord with intracranial extension : case report

Intradural lipomas are rare, histologically benign neoplasms that account for less than 1% of all spinal cord tumours. Extensive intramedullary lipomas of the cervical spinal cord extending into the posterior fossa are extremely rare, with only 8 cases reported in the literature. An intradural, intramedullary lipoma originating within the cervico-thoracic cord with significant extension into the posterior fossa is reported. The lipoma was found incidentally by CT scan at the infant’ s age of 2 days. Follow-up studies by CT and MRI were performed on several occasions. Because of hydrocephalus, ventriculoperitoneal shunting was performed. After shunting and shunt revisions, surgery of lipoma was performed at the age of 2 years. At this age, the patient’ s motor development, especially the lower extremity musculature, was retarded, corresponding to the age of 7-8 months. Due to the high operative risk, the patient’ s parents refused to give their consent for the suggested lipoma operation earlier. The surgery was performed to confirm the histologic diagnosis of the mass and to decompress the neural structures in the posterior cranial fossa and spinal canal. Posterior fossa craniectomy and laminectomy from C1 to T4 were performed. The lipoma was reduced by the microsurgical technique and with the use of a CO2 laser. Adequate decompression was achieved, leaving a relaxed pulsating cord and posterior fossa. Pathologic examination revealed a lipoma. The patient’ s postoperative course was uneventful. Postoperative treatment included rehabilitation that produced a good result. During the 12-month follow-up period, improvement of the motor deficit was recorded: the patient used both hands, was able to sit independently, and could walk with support.

intramedullary lipoma

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