Angiolipoma is a rare subtype of lipoma that contains both mature adipocytes and a rich vascular component. Infiltrating spinal angiolipomas causes surgical challenges with potential on-table injuries to adjacent structures. We present a rare case of infiltrating spinal angiolipoma in a 76-year-old woman who presented with paraplegia and hydrocephalus. At the time of presentation, the patient was bedridden for 3 months due to a complete loss of motor power. Imaging examination revealed a lesion involving the T6 vertebra with compressive myelopathy. The patient underwent spinal decompression and resection of the lesion, which turned out to be an infiltrating angiolipoma by histological examination. This is a unique case because spinal angiolipoma is extremely uncommon and such lesions generally manifest without infiltration. This case report highlights the existence and importance of spinal angiolipoma as a differential diagnosis of chronic backache resulting in neurological deficits and hydrocephalus.
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