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An Unusual Case Of Intramedullary Angiolipoma Of The Thoracic Spine 2013

Category General Spine Yasmin Koohi, M.D.
Julie Matsumoto, M.D.
Purpose To discuss the radiological and histopathological features of spinal intramedullary angiolipomas, utilizing a case from our institution. The importance of proper MRI protocol, including post-gadolinium fat saturated T1-weighted imaging, is demonstrated. Materials & Methods Using the electronic medical record, the patient's clinical history was reviewed. The patient's imaging studies, including MRI of the cervical and thoracic spine, were reviewed on PACS. Results The patient is a 67 year-old male who presents with a 5 year history of level 4 mid thoracic pain with sensation changes from T6 down to legs.  Additionally, he admits to bilateral leg numbness, tingling, and weakness and has to walk with a walker for fall prevention and pain.  The patient had a history of recent lumbar surgery. He subsequently underwent an MRI of the thoracic spine showing a large fat-containing intramedullary lesion spanning from T1 to T3 with an associated enhancing nodular component. This was favored to represent an intramedullary angiolipoma preoperatively, which was confirmed by pathology. Conclusion Angiolipomas of the spine are rare benign tumors containing vascular elements and mature adipose tissue. Spine involvement is typically extradural, with intramedullary spinal angiolipomas being extremely rare. We report a case of thoracic intramedullary angiolipoma with review of radiological and histopathological features. References
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