Case Report | Published:

Symptomatic spinal epidural lipomatosis after combined hormonal and steroidal palliative therapy of prostate cancer

Spinal Cord Series and Casesvolume 4, Article number: 75 (2018) | Download Citation

Abstract

Introduction

Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing’s syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration.

Case presentation

An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms. Spinal cord compression was excluded on the subsequent MRI. However, a spinal epidural lipomatosis causing significant central canal stenosis and compression of the cauda equine was revealed.

Discussion

With the increasing role of MRI in assessing back pain, asymptomatic spinal epidural lipomatosis has been frequently noticed. However, symptomatic presentation after long term combined treatment of steroids and hormonal therapy has not been reported in the literature.

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Author information

Affiliations

  1. NIHR Nottingham Biomedical Research Centre, Sir Peter Mansfield Imaging Centre (SPMIC), University of Nottingham, Nottingham, NG72UH, UK

    • Amir Awwad
  2. Radiology Department, Royal Papworth Hospital NHS Foundation Trust, Cambridge, CB23 3RE, UK

    • Amir Awwad
  3. Radiology Department, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK

    • Renan E. Ibrahem Adam
    •  & James D. Thomas
  4. Urology Department, Nottingham Urology Centre, City Hospital, Nottingham, NG5 1PB, UK

    • Chandni Patel

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Contributions

All listed authors have read, approved, and contributed sufficiently to take responsibility for the whole content of the manuscript following the criteria in ICJME guidelines for authorship rights and responsibilities.

Informed consent

An informed written consent for publication has been obtained from the patient.

Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to James D. Thomas.

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DOI

https://doi.org/10.1038/s41394-018-0107-2