Case Report

Spinal Cord (2008) 46, 243–244; doi:10.1038/sj.sc.3102099; published online 3 July 2007

Idiopathic spinal epidural lipomatosis without obesity: a case with relapsing and remitting course

A Akhaddar1, H Ennouali2, M Gazzaz1, O Naama1, B Elmostarchid1 and M Boucetta1

  1. 1Department of Neurosurgery, University of King Mohammed V Medical School, Mohammed V Military Hospital, Rabat, Morocco
  2. 2Department of Radiology, University of King Mohammed V Medical School, Mohammed V Military Hospital, Rabat, Morocco

Correspondence: Professor A Akhaddar, Department of Neurosurgery, Bloc V2, appt 5, Avenue Kamal Zebdi, Secteur 21, Hay Riyad, 10106, Rabat, Morocco. E-mail: akhaddar@hotmail.fr

Received 19 May 2007; Accepted 5 June 2007; Published online 3 July 2007.

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Abstract

Study design:

 

Case report of a rare form of idiopathic spinal epidural lipomatosis (SEL) manifesting with relapsing and remitting course.

Objective:

 

To describe this very rare clinical and pathological condition and the results of surgical intervention.

Setting:

 

A department of neurosurgery in Morocco.

Methods:

 

A 24-year-old man presented with a 2-year history of mid-thoracic back pain and progressive neurogenic claudication with two episodes of remitting and relapsing course. Spinal magnetic resonance imaging revealed a fatty epidural mass extending from T4 to T9. Posterior decompression was performed, and he was followed for 3 years after the operation.

Results:

 

Pathological examination of the surgical specimen revealed nodules of mature fat cells without neoplasm. The patient's symptoms completely resolved after surgical decompression.

Conclusion:

 

Fluctuating clinical course has not been reported previously in SEL. Such pathology should be considered in the differential diagnosis of demyelinating diseases.

Keywords:

epidural lipomatosis, myelopathy, MR imaging, obesity, treatment

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