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Lu T, Wang H, Liu Y, Qin X, Teng Y, Wang Y. Demographic and clinical data of patients with spinal epidural angiolipomas. Sci Rep 2024; 14:17473. [PMID: 39080392 PMCID: PMC11289124 DOI: 10.1038/s41598-024-67584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024] Open
Abstract
Spinal epidural angiolipomas are rare, benign, mesenchymal tumors. It remains unclear whether spinal epidural angiolipomas are genuinely rare or merely underreported. Herein, we assessed the demographic and clinical characteristics of patients with spinal epidural angiolipoma. We collected data from patients with spinal epidural angiolipoma from three sources. First, we retrospectively analyzed data from patients diagnosed with spinal epidural angiolipoma in our hospital between January 1, 2014, and December 31, 2023. Second, we performed a literature review of studies retrieved from PubMed. Third, we retrieved detailed data of patients with spinal angiolipoma from the Surveillance, Epidemiology, and End Results (SEER) database. We conducted a descriptive analysis to investigate the demographic and clinical characteristics of patients with spinal epidural angiolipoma. At our institution, three patients were diagnosed with spinal epidural angiolipoma. Additionally, we identified 116 patients from the literature review and 15 patients from the SEER database. We reviewed the treatment history and imaging features of the three patients from our institution. The descriptive analysis of the data collected from the literature review was consistent with previous reports. For example, 63.0% of lesions were located at the thoracic level. 31.9% of these lesions involved two vertebral bodies, while 75.6% involved 2-4 vertebral bodies. The most common symptoms experienced by patients were back pain, paraparesis, and numbness in the legs. Surgery was the primary treatment option for most patients, and complete tumor resection was achieved in the majority of patients. The male:female ratio was 1:1.4, the median age at diagnosis for the patients from the literature was 49 years old, and the median follow-up was 24 months. Notably, most of the reports came from Asia and there were few reports from Africa. The findings from the SEER database indicated a male:female ratio of 2:1. The peak incidence, which is typically reported in the fifth decade of life, was not observed. We presented three cases of spinal epidural angiolipoma and supplemented our findings with a literature review and population-based analysis according to the SEER database for the United States population. We believe that our research will enhance clinicians' comprehension of this uncommon tumor.
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Affiliation(s)
- Taikun Lu
- Department of Neurosurgery, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, Jilin, People's Republic of China
| | - Hao Wang
- Department of Neurology, First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Yang Liu
- Department of Radiology, First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Xiaowei Qin
- Department of Neurosurgery, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, Jilin, People's Republic of China
| | - Yongliang Teng
- Department of Pathology, First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Yubo Wang
- Department of Neurosurgery, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, Jilin, People's Republic of China.
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Benhayoun O, Makhchoune M, Jehri A, Yassine Haouas M, Hilmani S, Lakhdar A. Spinal extradural angiolipomas: A case report. Ann Med Surg (Lond) 2021; 65:102289. [PMID: 33912345 PMCID: PMC8066406 DOI: 10.1016/j.amsu.2021.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
Angiolipoma are benign tumors composed of mature adipocytes ad mixed with abnormal vascular elements. It reportedly accounts for 0.1–0.5% of all spinal axis tumors in adults and is extremely rare in children. This article describes a case of spinal extradural angiolipoma in a 35-year-old man, who presented with paraplegia and sphincter disorders, the MRI showed extradural spinal lesions at the level of T7 to T10, that squeezed the spinal cord. We attained total resection without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may imitate other spinal lesions. The gold standard treatment modality should always be surgery, however in some cases, total resection can not be done. This paper presents a 35-year-old man complaining for 1 months a numbness and lowerlimbs heaviness. The neurological examination revealed paraplegia with a muscle power was 2/5. However, in lower limbs, the deep tendon reflexes were absent, walking was impossible also without any sensitive disorder. MRI revealed T7-T10 extradural spinal lesion. The tumor appeared as an hyperintense on T1 and T2-weighted images, and as heterogeneous on STIR. Total resection after dissecting the tissue around the tumor. The histopathological examination of the specimens obtained, showed that the lesion was made up of fatty tissue and angioma-like tissue. SAL is a rare benign tumor and considered as a specific clinico-pathological entity. MRI is considered to be the “gold standard” in diagnosing SAL and surgery appears to be the treatment of choice.
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Affiliation(s)
- Othman Benhayoun
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Marouane Makhchoune
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Abdelhamid Jehri
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | | | - Said Hilmani
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
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Akyuva Y, Gonultas A, Karaaslan N, Gulciftci Dagci Z, Saglik S, Isyar M, Mahirogullari M. Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature. Open Neurol J 2017; 11:20-26. [PMID: 29151988 PMCID: PMC5678235 DOI: 10.2174/1874205x01711010020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/09/2017] [Accepted: 08/09/2017] [Indexed: 01/30/2023] Open
Abstract
Aim To describe a patient with lumbar angiolipoma mimicking schwannoma in the posterolateral side of the spinal canal with expansion of the left lumbar foramen and to discuss the clinical, radiologic, and surgical features of these lesions with literature. Methods Without language restriction in this paper, the electronic databases; The Cochrane Collaboration the Cochrane, The Cochrane Library (Issue 2 of 12, Feb. 2011), ProQuest, US National Library of Medicine, National Institutes of Health (NLM) and PubMed dating from 1966 September to January Week 2 2017, were searched for comparative experimental studies using the terms: "OR", "AND". On-line literature searches were conducted using the key words "lumbar angiolipoma", "schwannoma ", "spinal angiolipoma", "spinal cord", and "spinal canal". We compared this research with our patient. Results Bilateral L2 total laminectomy, excision of the tumors and bilateral L2-L3 transpedicular stabilization were performed, and complaints improved prominently. Pathological examination was reported as angiolipoma. Conclusion The research shows that a probable diagnosis in such tumor cases could be made by sufficient pre-op scanning before surgical operations and although angiolipoma has been rarely seen in lumbar posterolateral space, it can be seen in lumbar region and mimic schwannoma as producing symptoms and signs of spinal cord and nerve root compression.
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Affiliation(s)
- Yener Akyuva
- Republic of Turkey, Ministry of Health, State Hospital, Department of Neurosurgery, 59100, Tekirdag, Turkey
| | - Aylin Gonultas
- Republic of Turkey, Ministry of Health, State Hospital, Department of Pathology, 59100, Tekirdag, Turkey
| | - Numan Karaaslan
- Namik Kemal University School of Medicine, Department of Neurosurgery, 59030, Tekirdag, Turkey
| | - Zehra Gulciftci Dagci
- Republic of Turkey, Ministry of Health, State Hospital, Department of Pathology, 59100, Tekirdag, Turkey
| | - Semih Saglik
- Republic of Turkey, Ministry of Health, State Hospital, Department of Radiology, 56100, Siirt, Turkey
| | - Mehmet Isyar
- Medicalpark Bahcelievler, Department of Orthopaedic and Traumatology, 34050, Istanbul, Turkey
| | - Mahir Mahirogullari
- Istanbul Memorial Health Group, Department of Orthopaedic and Traumatology, 34758, Istanbul, Turkey
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Onishi FJ, Salem FAS, de Melo Lins DL, Dauar RFB, Stavale JN. Spinal thoracic extradural angiolipoma manifesting as acute onset of paraparesis: Case report and review of literature. Surg Neurol Int 2017; 8:150. [PMID: 28791193 PMCID: PMC5525459 DOI: 10.4103/sni.sni_467_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/22/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Angiolipomas are benign tumors most commonly found in the thoracic spine. They are composed of mature adipocytes and abnormal vascular elements that usually present with a slowly progressive course of neurological deterioration. CASE DESCRIPTION A 35-year-old female, with a prior history of back pain, acutely developed paraparesis. When the thoracic magnetic resonance imaging (MRI) revealed a dorsal epidural mass at the T3-T5 level, she underwent a laminectomy for gross total excision of the lesion that proved to be an angiolipoma. On the second postoperative day, the patient was again able to ambulate. CONCLUSION The angiolipomas of spine are rare causes of spinal cord compression, and those presenting with acute neurological deficits should be immediately treated.
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Benvenutti-Regato M, De la Garza-Ramos R, Caro-Osorio E. Thoracic epidural spinal angiolipoma with coexisting lumbar spinal stenosis: Case report and review of the literature. Int J Spine Surg 2015; 9:67. [PMID: 26767159 PMCID: PMC4710163 DOI: 10.14444/2067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Spinal angiolipomas (SALs) are uncommon benign lesions that may present insidiously with back pain or acutely with weakness due to tumor bleeding/thrombosis. Given their rarity, these lesions are often overlooked in the differential diagnosis of epidural masses. The purpose of this article is to report the case of an epidural SAL and to conduct a literature review on the topic. METHODS A case report and review of the literature using the PubMed/Medline databases. All case reports and case series were reviewed up to June 2015. RESULTS A 65-year old female presented with neurogenic claudication and magnetic resonance imaging (MRI) revealed lumbar spinal stenosis. Following decompressive surgery, she experienced symptom resolution, but three months postoperatively she presented to the emergency department with acute paraparesis. A thoracic MRI revealed a lesion located between T8 and T10 causing severe spinal cord compression. Following emergent laminectomy and en bloc resection, the patient regained function and the lesion was diagnosed as SAL. Our literature review revealed 178 reported cases, with a female and thoracic predominance. The majority of patients underwent surgical treatment, achieving a gross total resection in most cases. Similarly, complete symptom resolution was the most common outcome. CONCLUSION Spinal angiolipomas are uncommon spinal tumors. However, they may be treated as any other space-occupying lesion, and surgical resection allows for complete symptom recovery in most patients.
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Affiliation(s)
- Mario Benvenutti-Regato
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
| | - Rafael De la Garza-Ramos
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
| | - Enrique Caro-Osorio
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
- Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
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Abstract
Angiolipomas of the spine are rare benign tumors commonly presenting with compressive myelopathy. The present report describes a case of spinal angiolipoma with thoracic mediastinal extension in a 50-year-old woman. She presented with a long-standing history of mid-back pain with progressive lower extremities weakness. An MRI showed a heterogeneously enhancing mass located in the posterior epidural space of the thoracic spine with mediastinal extension. Histopathological examination demonstrated features consistent with spinal angiolipoma. This report emphasizes the diagnosis and therapeutic management options of infiltrating spinal angiolipomas.
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Affiliation(s)
- Mustafa M Nadi
- Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada. E-mail:
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Meng J, Du Y, Yang HF, Hu FB, Huang YY, Li B, Zee CS. Thoracic epidural angiolipoma: A case report and review of the literature. World J Radiol 2013; 5:187-192. [PMID: 23671756 PMCID: PMC3647212 DOI: 10.4329/wjr.v5.i4.187] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 12/18/2012] [Accepted: 01/21/2013] [Indexed: 02/06/2023] Open
Abstract
Angiolipoma of the spine is a benign neoplasm consisting of both mature fatty tissue and abnormal vascular elements, and usually presents with a slow progressive clinical course. Our patient presented with bilateral lower extremity weakness and chest-back numbness. Physical examination revealed adipose elements superficial hypesthesia below the T5 level and analgesia below the T6 level. Magnetic resonance imaging (MRI) scan showed an avidly and heterogeneously enhancing mass which was located in the posterior epidural space. Compression of the thoracic cord by the fusiform mass was seen between T3-T4. During the operation, a flesh pink vascular mass (4.7 cm × 1.0 cm × 1.0 cm) with obscure margin and strong but pliable texture was found in the posterior epidural space extending from T3 to T4. There was no infiltration of the dura or the adjacent bony spine. Histopathological study of the surgical specimen showed a typical angiolipoma. We review the previously documented cases of spinal extradural angiolipomas performed with MRI.
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Spinal extradural angiolipoma: report of two cases and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2009; 18:324-35. [PMID: 19127373 DOI: 10.1007/s00586-008-0858-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 10/26/2008] [Accepted: 12/10/2008] [Indexed: 10/21/2022]
Abstract
Spinal angiolipomas are benign uncommon neoplasm composed of mature lipocytes admixed with abnormal blood vessels. They account for only 0.04-1.2% of all spinal tumors. We report two cases of lumbar extradural angiolipoma and review previously reported cases. We found 118 cases of spinal epidural angiolipoma (70 females and 48 males; age range 1.5-85 years, mean 44.03) spanning from 1890 to 2006. Prior to diagnosis 40.6% of the patients had weakness of the lower limbs. The interval between the initial symptoms and tumor diagnosis ranged from 1 day to 17 years (mean 20.2 months). Except for four cases diagnosed at autopsy, 109 patients underwent surgery and gross-total resection was performed in 79 cases (72.4%). Spinal angiolipomas are tumors containing angiomatous and lipomatous tissue, predominantly located in the mid-thoracic region. All angiolipomas show iso- or hyperintensity on T1-weighted images and hyperintensity on T2-weighted images and most lesions enhance with gadolinium administration. The treatment for spinal extradural angiolipomas is total surgical resection and no adjuvant therapy should be administered.
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Nanassis K, Tsitsopoulos P, Marinopoulos D, Mintelis A, Tsitsopoulos P. Lumbar spinal epidural angiolipoma. J Clin Neurosci 2008; 15:460-3. [DOI: 10.1016/j.jocn.2006.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 11/03/2006] [Accepted: 11/08/2006] [Indexed: 10/22/2022]
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