Spinal intradural subpial angiolipoma: Case report and review of literature

Background: Spinal angiolipomas are rare tumors consisting of mature adipose tissue and abnormal vascular elements. Intradural location is very rare, and till now, only seven cases have been reported in literature. Authors report a case of an intradural intramedullary (subpial) angiolipoma located in the thoracic cord.

Case Description: A 26-year-old patient presented with features of progressive myelopathy of relatively short duration. Imaging showed a heterogeneous fat-containing intradural lesion at D5-D9 level, which enhanced on contrast enhanced fat saturation sequences. Subtotal excision was performed and patient had partial recovery of his neurological deficits. Histopathology was suggestive of angiolipoma.

Conclusions: Intradural angiolipomas are very rare. Complete excision often leads to neurological deficits. Hence, safe maximal decompression would suffice leading to long-term recurrence-free periods.