- Department of Neurosurgery, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
- Department of Neurosurgery, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India
- Department of Neuroradiology, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Arif H. Sarmast
Department of Neuroradiology, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
DOI:10.4103/sni.sni_38_18Copyright: © 2018 Surgical Neurology International This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
How to cite this article: Abrar A. Wani, Arif H. Sarmast, Altaf U. Ramzan, Abdul Q. Khan, Sarabjit S. Chhibber, Nayil K. Malik, Feroz Shaheen. Spinal angiolipoma mimicking a schwannoma: A case report. 10-Apr-2018;9:79
How to cite this URL: Abrar A. Wani, Arif H. Sarmast, Altaf U. Ramzan, Abdul Q. Khan, Sarabjit S. Chhibber, Nayil K. Malik, Feroz Shaheen. Spinal angiolipoma mimicking a schwannoma: A case report. 10-Apr-2018;9:79. Available from: http://surgicalneurologyint.com/surgicalint-articles/spinal-angiolipoma-mimicking-a-schwannoma-a-case-report/
Background:Angiolipomas rarely involve the spinal canal/foramina, and may prove difficult to differentiate from schwannomas.
Case Description:Here we report a patient who presented with a spinal angiolipoma contributing to spinal cord and neural foraminal compression that was difficult to differentiate from a schwannoma.
Conclusion:Spinal angiolipomas rarely involve the spinal canal/foramina. Utilizing neurodiagnostic studies with pathological confirmation, these lesions may be differentiated from schwannomas.
Keywords: Angiolipoma, spine, tumor
Spinal angiolipomas are benign tumors of adipose tissue that rarely involve the spinal neuraxis.[
The two major pathological types include the noninfiltrating vs. infiltrating variants. The former noninfiltrating angiolipomas are more common, well-capsulated lesions; the patient we present had a thoracic lesion.[
Clinical and radiographic presentation
A 60-year-old male presented with progressive weakness in the right (3/5) greater than the left (4/5) lower extremities. The thoracic magnetic resonance imaging (MRI) revealed an extradural tumor at the D-6-7 level that was hyperintense on both T1 and T2-weighted images and enhanced with contrast [
During the D-6-7 laminectomy, the tumor was found to extend from dorsal to the dura and into the left neural foramen. Although it first appeared to be a schwannoma, its vascular areas containing well-encapsulated fat were consistent with a fat angiolipoma. Histopathology confirmed this diagnosis, documenting multiple small blood vessels and intervening areas of fat. The postoperative MRI showed no evidence of residual tumor, and the patient regained normal function within five postoperative weeks.
Benign infiltrating spinal epidural angiolipomas are rare benign tumors They are composed of mature adipocytes and proliferating blood vessels. They predominantly appear in middle-aged females and males.[
These tumors are divided into two histological subtypes: infiltrating and noninfiltrating (benign).[
Neurodiagnostic studies of angiolipomas
Diagnosing angiolipomas on X-rays, MRI, and CT studies and differentiating them from schwannomas may be difficult. Plain X-rays are usually negative, only showing changes where infiltration of vertebral bodies by tumor causes a loss of trabeculation.[
Pathologically, angiolipomas contain mature adipocytes, fibrinous material, and many small blood vessels. Thin fibrous capsules with fibrous septa usually divide these masses into lobules. There are often fibrinous microthrombi within the lumen of its capillaries (e.g., containing some fibrin thrombi).[
The mainstay of treatment is complete surgical excision.[
Spinal angiolipomas, both the infiltrating and nonfiltrating variants, are rare, well-defined tumors. The treatment for both types is gross total surgical excision. Notably, as patients with residual, infiltrating lesions have good prognoses, they do not require additional radiation therapy.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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