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      Pediatric Nondysraphic Intramedullary Lipoma : Report of Two Cases and Review of the Literature

      case-report

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          Abstract

          Pediatric nondysraphic intramedullary lipoma is very rare, and only limited cases have been reported. In the present case, we present two infant patients with these pathologies who were surgically treated. Previous literature on 20 patients with these diseases who had undergone surgical treatments was analyzed. Surgical treatment should be considered in most symptomatic patients, and laminoplastic laminotomy and internal debulking of the lipoma under intraoperative neurophysiological monitoring are mostly recommended.

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          Intramedullary spinal cord lipomas.

          A R Rezai, Henry F. Epstein, Edgar D Coelho … (1995)
          Spinal cord lipomas are rare lesions, accounting for approximately 1% of all spinal cord tumors. True intramedullary spinal cord lipomas are extremely rare and are represented in the literature as scattered, single case reports. The authors present a series of six patients with intramedullary spinal cord lipomas managed at our institution from July, 1985 to July, 1993. The patients' ages ranged from 8 to 45 years. Four patients presented with newly diagnosed tumors and two had undergone previous surgery. Patients usually presented with long histories of disability followed by rapid progression of their symptoms. Most patients were in poor neurological condition on presentation. Presenting symptoms included spinal pain, dysesthetic sensory changes, gait difficulties, weakness, and incontinence. Three patients had cervical tumors, two had cervicothoracic tumors, and one patient had a thoracic tumor. Diagnostic studies, including magnetic resonance imaging, were obtained in all patients. No patient exhibited any form of spinal dysraphism or had a dural defect. All patients underwent decompressive, subtotal resections of 40% to 70% of their lesions. Follow-up times ranged from 12 to 96 months. All patients had resolution of their pain, but they generally showed no neurological improvement. As of their most recent follow-up visit, none of the patients was neurologically normal; three can function independently, although with neurological deficits. The other three patients cannot function independently and have severe neurological deficits. The authors conclude that patients with intramedullary spinal cord lipoma who present with significant neurological compromise have a very poor prognosis with regard to neurological function and generally show no improvement with surgical resection.
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            Asymptomatic lumbosacral lipomas--a natural history study.

            Victoria Wykes, Dominic N. P. Thompson, Divyesh Y. Desai (2012)
            Inevitable deterioration due to mechanical tethering is perceived as the natural history for complex congenital spinal lipomas of the conus medullaris region, even if asymptomatic at presentation. The conventional wisdom that prophylactic surgical untethering improves outcome has been challenged recently [1, 2]. This study examines the natural history of asymptomatic un-operated children with lumbosacral lipomas (LSL) and investigates whether predictive factors herald deterioration.
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              Lipomyelomeningocele: pathology, treatment, and outcomes.

              Christina E. Sarris, Krystal Tomei, Peter Carmel … (2012)
              Lipomyelomeningocele represents a rare but complex neurological disorder that may present with neurological deterioration secondary to an inherent tethered spinal cord. Radiological testing is beneficial in determining the morphology of the malformation. Specialized testing such as urodynamic studies and neurophysiological testing may be beneficial in assessing for neurological dysfunction secondary to the lipomyelomeningocele. Early surgical intervention may be beneficial in preventing further neurological decline.
              Article 0 comments Cited 13 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Korean Neurosurg Soc
                Journal ID (iso-abbrev): J Korean Neurosurg Soc
                Journal ID (publisher-id): JKNS
                Title: Journal of Korean Neurosurgical Society
                Publisher: Korean Neurosurgical Society
                ISSN (Print): 2005-3711
                ISSN (Electronic): 1598-7876
                Publication date (Print): March 2023
                Publication date (Electronic): 8 September 2022
                Volume: 66
                Issue: 2
                Pages: 211-218
                Affiliations
                [1 ]Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
                [2 ]Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Busan, Korea
                [3 ]Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
                Author notes
                Address for correspondence : Ji Hoon Phi Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel : +82-2-2072-3639, Fax : +82-2-744-8459, E-mail : phi.jihoon@ 123456gmail.com
                Author information
                http://orcid.org/0000-0003-1423-2681
                http://orcid.org/0000-0002-4689-8974
                http://orcid.org/0000-0002-9825-8194
                http://orcid.org/0000-0002-0039-0083
                http://orcid.org/0000-0002-9603-5843
                Article
                Publisher ID: jkns-2022-0156
                DOI: 10.3340/jkns.2022.0156
                PMC ID: 10009248
                PubMed ID: 36071566
                SO-VID: 8d2e960a-3fe8-45db-8f65-51c3e8c99166
                Copyright © Copyright © 2023 The Korean Neurosurgical Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 1 July 2022
                Date revision received : 28 August 2022
                Date accepted : 6 September 2022
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: spinal cord neoplasms,lipoma,neurologic manifestations,laminoplasty
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: spinal cord neoplasms, lipoma, neurologic manifestations, laminoplasty

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