epidural angiolipoma

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Epidural angiolipomas are rare benign tumors composed of mature adipocytes and abnormal vessels.

Epidemiology

Epidural angiolipomas are more frequently encountered in women, and typically in middle age (40-50 years of age) .

Clinical presentation

In keeping with the slow growth of these tumors, clinical presentation is usually gradual with symptoms often present over a number of months/years. Signs and symptoms include:

  • paraparesis
  • back pain
  • sensory changes (lower limbs) 
  • hyper-reflexia (lower limbs) 

Radiographic features

Angiolipomas can be divided into infiltrating and non-infiltrating varieties, and both as seen in the epidural space. Non-infiltrating angiolipomas are more common and are usually located in the dorsal epidural space, typically in the thoracic region . Infiltrating angiolipomas are more common in the anterior epidural space, and can infiltrate not only adjacent soft tissues, but also adjacent vertebrae .

CT

CT demonstrates a mixture of soft tissue density and fatty components.

MRI

Signal characteristics are as expected from the composition of this tumor:

  • T1
    • high signal fatty component
    • intermediate signal vascular component
  • T2
    • high signal
    • flow voids are usually absent but enlarged vessels in the region may be visible
  • T1 C+ (Gd)
    • vivid enhancement of non-fatty components

Treatment and prognosis

Surgical resection is the treatment of choice, particularly for non-infiltrating tumors, in which case complete resection is possible and curative .

Malignant transformation has not been reported .

Differential diagnosis

Differential diagnosis includes other epidural masses :

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu epidural angiolipoma:
epidurale
intraspinale Raumforderung
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