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Research ArticleArticles

Thoracic epidural spinal angiolipoma with coexisting lumbar spinal stenosis: Case report and review of the literature

Mario Benvenutti-Regato, Rafael De la Garza-Ramos and Enrique Caro-Osorio
International Journal of Spine Surgery January 2015, 9 67; DOI: https://doi.org/10.14444/2067
Mario Benvenutti-Regato
1Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
2Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
MD
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Rafael De la Garza-Ramos
1Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
2Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
MD
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Enrique Caro-Osorio
1Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México
2Neurology and Neurosurgery Institute, Centro Médico Hospital Zambrano Hellion, TecSalud, Monterrey, México
MD
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  • Fig. 1
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    Fig. 1

    Magnetic resonance image showing lumbar spinal stenosis. Sagittal (A) and axial (B) T2-weighted images showing lumbar spinal stenosis at L4/L5 secondary to ligamentum flavum hypertrophy and bilateral facet arthropathy. Sagittal (C) and axial (D) T2-weighted images showing foraminal stenosis on the left secondary to facet arthropathy at L5/S1.

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    Fig. 2

    Magnetic resonance image showing an epidural lesion extending from T8 – T10. Sagittal (A) and axial (B) T1-weighted images showing the dumbbell-shaped hyperintense lesion extending multiple levels and through the foramen at T9/T10. Additionally, the lesion shows hypointense regions, corresponding to the vascular component of the tumor. Sagittal (C) and axial (D) T2-weighted images showing severe spinal stenosis with spinal cord compression.

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    Fig. 3

    Intraoperative photographs showing a reddish-brown lesion overlying the thecal sac (Left) which was removed en bloc following laminectomy (Right).

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    Fig. 4

    Tumor specimen consisting of a soft, reddish-brown mass (Left). Histological slide showing mature adipocytes and blood vessels of various sizes, some filled with thrombin (Right).

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    Table 1

    Review of published cases on epidural spinal angiolipoma.

    AuthorYearAge, sexFirst symptomLevelAxial locationInfiltratingTreatmentOutcome
    Berenbruch189016/MParaparesisThoracicNot availableNSurgery
    Liebscher190151/FNumbnessT7-T8AnteriorNNo surgery
    Frazier and Allen191855/FThoracicUnknownNUnknownUnknown
    Balado and Morea192820/FParaparesisMidthoracicUnknownNNo surgery
    Kasper and Cowan19296/MBleeding to lumbar punctureC2-T1 and L3-S3UnknownNNo surgery
    Petit-Dutaillis and Christoph193143/FParaplegiaT6-T10UnknownNSurgeryRecovery
    Ehni and Love194530/FParaplegiaT6-T8PosteriorNSurgeryRecovery
    Ehni and Love194567/MParaparesisT8-T9PosteriorNSurgeryRecovery
    Bucy and Ritchey194733/MParaparesisC6-T5PosterolateralNSurgery+RTImproved
    Taylor et al.195151/FParaparesisT3-T6PosteriorNSurgeryImproved
    Taylor et al.195144/FParaparesisT10-L1PosteriorYSurgeryImproved
    Moscatelli and Merigliano195851/MT4-T7PosteriorNUnknownUnknown
    Maier19621.5/FParaparesisT7AnteriorYSurgeryRecovery
    Gonzalez-Crusi et al.196620/FLBPL1-L4AnteriorYSurgery+RTRecovery
    Gagliardi and Gambacorta196830/MParaparesisT3-T4PosteriorNUnknownUnknown
    Lo Re and Michelacci196916/MCongenitalCaudaPosteriorNSurgeryRecovery
    Lo Re and Michelacci196935/FLumbarPosteriorNSurgeryRecovery
    Warot and Petit196957/FParaparesisT4-T6PosteriorNUnknownUnknown
    Pearson et al.197017/FBack painT2-T5AnteriorYSurgeryImproved
    Pearson et al.197022/MBack painT3-T9AnteriorYSurgeryImproved
    Pearson et al.197044/FNumbnessT7-T10PosteriorNSurgeryRecovery
    Henry et al.197163/MParaparesisCervicothoracicPosteriorNNo surgeryDeath due to other causes
    Giuffré197136/FT4-T8UnknownNUnknownUnknown
    Bender et al.197450/FParaparesisT6-T8PosteriorNSurgeryRecovery and late recurrence
    Bender et al.197458/MParaparesisT7-T10PosteriorNSurgeryImproved
    Scanarini and Carteri197457/FParaplegiaT7PosteriorNSurgeryRecovery
    Obrador et al.197743/FLeg painT7-T9PosteriorNSurgeryRecovery
    Occhiogrosso &Vailati197734/FNumbnessT6-T8PosteriorNSurgeryRecovery
    Cull et al.197850/FParaparesisT8-T9PosteriorNSurgeryRecovery
    Cull et al.197845/FParaparesisT6-T8PosteriorNSurgeryImproved
    Shuangshoti and Hongsagrabhas197945/MT10-T11PosteriorNSurgeryRecovery
    Schiffer et al.198048/FNumbnessT10-L1AnteriorYSurgeryRecovery
    Goyal198067/FParaparesisPosterolateralNSurgeryDead
    Miki et al.198146/FNumbnessT3-T5PosteriorNSurgeryRecovery
    Padovani et al.198250/MParaparesisT4-T6PosterolateralNSurgeryRecovery
    Padovani et al.198252/MParaparesisT4-T6PosteriorYSurgeryImproved
    Hanakita and Koyama198242/MGait disturbanceT4-T5PosteriorNSurgeryRecovery
    Pasquier et al.198448/FT8-T10PosteriorNSurgeryImproved
    Butti et al.198444/MParesthesia right armC6-C7PosteriorNSurgeryRecovery
    Butti et al.198450/FNumbness in legsL4-L5PosteriorNSurgeryRecovery
    Bardosi et al.198546/MLBPT11-L2PosteriorNSurgeryRecovery
    Von Hanwehr et al.198535/MNumbness of right footT6AnteriorYSurgeryRecovery
    Haddad et al.198634/MNumbness of legsT5-T6PosteriorYSurgeryImproved
    Haddad et al.198622/MBack painT7-T8PosteriorNSurgeryRecovery
    Griebel et al.198653/FParaparesisT5-T6PosteriorNSurgeryRecovery
    Nishiura et al.198642/MNumbness in legsT3-T6PosteriorNSurgeryImproved
    Nishiura et al.198624/MLBPL5-S1AnterolateralNSurgeryRecovery
    Nishiura et al.198645/MNumbness in legsT3-T6PosteriorNSurgeryImproved
    Matsushima et al.198741/FParaparesisT9-T10PosteriorNSurgeryRecovery
    Rivkind et al.198652/MParaparesisT7AnterolateralNSurgeryRecovery
    Poon et al.198865/FBack painT8-T9PosteriorNSurgeryRecovery
    Parizel198937/FT4-T8UnknownNSurgery
    Anson et al.199058/FBack painT2-T6PosterolateralNSurgery+RTRecovery
    Anson et al.199065/FParaparesisT1-T8PosteriorNSurgeryUnchanged
    Kuroda et al.199073/FNumbness in left legT4PosteriorYSurgeryImproved
    Weill et al.199146/FParaparesisT7-T10PosteriorNSurgeryRecovery
    Mascalchi et al.199142/FNumbness of left toeT5-T6PosteriorNSurgeryRecovery
    Rubin et al.199258/MParaparesisT8-T10PosteriorNSurgeryImproved
    Stranjalis et al.199268/FParaparesisT5-T6PosteriorYSurgeryImproved
    Pagni and Canavero199256/FLBPL3AnteriorNSurgeryRecovery
    Pagni and Canavero199259/FLBPL4-L5AnteriorNSurgeryRecovery
    Mimata199260/MT5-T8UnknownNSurgeryRecovery
    Yamashita et al.199357/MGait disturbanceT3-T9PosteriorNSurgeryRecovery
    Shibata199338/FParaparesisT4-T6UnknownNSurgeryRecovery
    Preul et al.199345/FNumbness in legsT7-T11PosteriorNSurgeryRecovery
    Preul et al.199358/MBack painT3PosteriorYSurgeryUnchanged
    Michilli et al.199312/MLBPT5-T10PosteriorNSurgeryRecovery
    Sakaki et al.199367/MLeg painT12-L1LateralNSurgeryRecovery
    Fernandez et al.199414/FParaplegiaT5PosteriorNSurgeryImproved
    Fernandez et al.199428/MParaplegiaC7-T4PosteriorNSurgeryUnchanged
    Turanzas et al.199425/MParaparesisT6-T8AnteriorYSurgeryImproved
    Balbo199541/MParaparesisT6-T7PosteriorNSurgeryRecovery
    Bouramas199527/FNumbness in legsT2-T8PosteriorNSurgeryRecovery
    O‘Donovan199654/MBack painT3-T9PosteriorNSurgeryRecovery
    Trabulo et al.199626/FBack painT2-T9PosteriorNSurgeryRecovery
    Trabulo et al.199672/MParaparesisT6PosteriorYSurgeryRecovery
    Provenzale & McLendon199638/FLBPLumbarPosteriorNSurgeryUnknown
    Provenzale & McLendon199661/FParaparesisThoracic (2 tumors)PosteriorNSurgeryUnknown
    Provenzale & McLendon199642/FBack painThoracicPosteriorNSurgeryUnknown
    Krishnan et al.199655/FParaparesisT6-T9PosteriorNSurgeryRecovery
    Boockvar et al.199734/FBack painT3-T9PosteriorNSurgeryRecovery
    Shuangshoti & Lerdlum199721/MParaparesisT1-T2PosteriorNSurgeryRecovery
    Sakaida199872/MNumbness in legsT3-T5AnteriorYSurgeryRecovery
    Labram et al.199940/FBack painC6-T3PosterolateralNSurgeryRecovery
    Labram et al.199968/FBack painT5-T10PosteriorNSurgeryRecovery
    Labram et al.199917/MBack painC5-T3CircumferentialNSurgeryRecovery
    Turgut199954/FParaparesisT4-T9PosteriorNSurgeryRecovery
    Kujas199967/FParaparesisT6AnteriorNSurgeryWorsened
    Oge et al.199972/MParaparesisT2-T5PosteriorNSurgeryRecovery
    El Abbadi199938ParaparesisT10-T11PosteriorNSurgeryRecovery
    Bailey et al.200044/FNumbness in legsT3-T8PosteriorNSurgeryRecovery
    Al-Anazi et al.200038/FNumbness of both legsT5-T9PosteriorNSurgeryRecovery
    Andaluz et al.200024/FParaparesisT7-T10PosteriorNSurgery+embolizationRecovery
    Andaluz et al.200039/FNumbness in legsT6-T8PosteriorNSurgeryRecovery
    Andaluz et al.200059/FParaparesisT4-T6PosteriorNSurgeryRecovery
    Andaluz et al200069/MParaparesisT3-T4PosteriorNSurgeryRecovery
    Akhaddar et al.200047/FNumbness in legsT4-T6PosteriorNSurgeryRecovery
    Akhaddar et al.200046/FParaparesisT7-T9PosteriorNSurgeryRecovery
    Akhaddar et al.200038/FNumbness in legsT3-T5PosteriorNSurgeryRecovery
    Akhaddar et al.200046/FParaparesisT3-T4PosteriorNSurgeryRecovery
    Akhaddar et al.200012/FParaparesisT7-T8PosteriorNSurgeryImproved
    Akhaddar et al.200064/FLeg painT2-T4PosterolateralNSurgeryRecovery
    Akhaddar et al.200058/MNumbness in legsT3-T6PosteriorNSurgeryRecovery
    Akhaddar et al.200047/MBack painT3-T6PosteriorNSurgeryImproved
    Amlashi et al.200136/FLBPT2-T6PosteriorNSurgeryImproved
    Fourney et al.200146/FNumbness in legsT6-T8PosteriorNSurgeryRecovery
    Garg et al.200212/FParaparesisT1-T11PosterolateralNSurgeryImproved
    Gelabert et al.20024/MParaparesisT2-T5PosteriorNSurgeryRecovery
    Pinto et al.200285/MLeg painL1-L2PosteriorNSurgeryImproved
    Samdani et al.200449/FLBPT6-T8PosteriorNSurgeryRecovery
    Aversa do Souto et al.200346/FLBPL4-L5AnteriorNSurgeryRecovery
    Rocchi et al.200460/MLeg painL3-L4AnteriorNSurgeryRecovery
    Rocchi et al.200454/FLeg painL3AnteriorNSurgeryRecovery
    Rabin et al.200447/MNumbness in legsT9AnteriorYEmbolization+SurgeryRecovery
    Petrella et al.200516/MLBPT4-T8PosteriorNSurgeryRecovery
    Cubillos et al.200540/FNumbness in legsT4-T7PosteriorNSurgeryRecovery
    Konya et al.200660/FLBPL5PosterolateralNSurgeryRecovery
    Dogan et al.200650/FLeg painL4-L5PosteriorNSurgeryRecovery
    Dogan et al.200636/MLBPL2PosteriorNSurgeryRecovery
    Raghavendra et al200714/FSubarachnoid hemorrhage and acute back painT1-T9PosteriorNNo surgeryUnchanged
    Guzey et al.200741/FLBP and leg painL2-L3PosterolateralYSurgeryRecovery
    Akhaddar et al.200847/MParaparesisT2-T3PosteriorNSurgeryRecovery
    Nanassis et al.200847/FLBP and leg painL2-L3PosteriorNSurgeryRecovery
    Farooq et al.200857/FLBP and numbness in legsT5-T8PosteriorNSurgeryRecovery
    Yen et al.200871/MBack pain and progressive paraparesisT5-T6PosteriorYSurgeryRecovery
    Hungs et al.200852/FBack pain and leg painT2-T5PosteriorNSurgeryRecovery
    Park et al.200874/MLBPL5-S1LateralNSurgeryRecovery
    Gelabert-Gonzalez et al.200916/MLBPL5-S1PosteriorNSurgeryRecovery
    Gelabert-Gonzalez et al.200945/FParaparesis and numbnessL5-S1PosteriorNSurgeryImproved
    Dufrenot et al.201044/FSurgeryRecovery
    Sankaran et al.201077/MPost-traumatic bleeding and acute paraparesisT8-T10PosteriorNSurgeryRecovery
    Haji et al.201165/FNumbness in legsT5-T7PosteriorNSurgeryImproved
    Diyora et al.201120/MBack pain and paraparesisT5-T8PosteriorNSurgeryRecovery
    Tsutsumi et al.201131/FParaplegiaT3-T4PosterolateralNSurgeryRecovery
    Chotai et al.201168/MBack pain and numbness in legsT9-T11PosteriorNSurgeryRecovery
    Han et al.201258/MLeg dysesthesia and paraparesisT4-T5PosterolateralYSurgeryRecovery
    Ghanta et al.201256/MLeg numbness and gait disturbanceT4-T5PosteriorNSurgeryImproved
    Fujiwara et al.201364/FLeg dysesthesiaT5-T8PosteriorNSurgeryRecovery
    Fujiwara et al.201365/MLeg dysesthesia and gait disturbanceT5-T7PosteriorNSurgeryRecovery
    Reyes et al.201368/MLBPT10-L1PosteriorNSurgeryRecovery
    Si et al.201450/MNRL3-L4PosteriorNSurgery
    Si et al.201453/MNRT4-T7PosteriorNSurgeryImproved
    Si et al.201458/MNRT9-T10PosteriorNSurgeryRecovery
    Si et al.201441/FNRT5-T6PosteriorNSurgery
    Si et al.201419/FNRC3-C6PosteriorNSurgery
    Si et al.201426/FNRC4-C6PosterolateralNSurgery
    Si et al.201463/FNRT7-T10PosteriorNSurgeryImproved
    Si et al.201462/FNRT8-T10PosteriorNSurgeryRecovery
    Si et al.201474/FNRL4-L5LateralNSurgeryRecovery
    Si et al.201455/MNRT3-T5LateralNSurgeryRecovery
    Si et al.201462/MNRL4-L5PosteriorYSurgeryRecovery
    Si et al.201461/MNRT11-L3PosteriorYSurgery
    Si et al.201443/FNRT7-T9PosterolateralNSurgeryImproved
    Si et al.201457/MNRT5-T8PosteriorNSurgery
    Si et al.201469/FNRT4-T6PosterolateralNSurgeryUnchanged
    Si et al.201462/MNRT4-T6PosteriorNSurgeryImproved
    Si et al.201447/FNRT2-T3PosteriorYSurgeryImproved
    Si et al.201450/FNRT2-T4PosterolateralNSurgery
    Si et al.201437/MNRT4-T7PosteriorNSurgery
    Si et al.201451/FNRT4-T5PosteriorNSurgery
    Si et al.201459/FNRT8-T11Surgery
    Ramdasi et al.201458/MParaplegiaC7-T1SurgeryRecovery
    Wang et al.201447/FParaparesisT3-T10PosteriorNSurgeryImproved
    Wang et al.201436/MLeg painL3-S2PosteriorNSurgeryRecovery
    Wang et al.201446/FBack painT2-T4LateralYSurgeryRecovery
    Wang et al.201450/MBack painT1-T3PosteriorNSurgeryRecovery
    Wang et al.201447/FNumbness in legsL2-L4PosteriorNSurgeryImproved
    Wang et al.201446/MParaparesisT11-T12PosteriorNSurgeryRecovery
    Wang et al.201454/MLeg painL3-L4PosterolateralYSurgeryImproved
    Wang et al.201444/FNumbness in legsT8-T11PosteriorNSurgeryRecovery
    Wang et al.201455/FLeg painL5-S1PosteriorNSurgeryImproved
    Wang et al.201447/MLBPL2-L3PosteriorNSurgeryImproved
    Wang et al.201449/FLBPL2-L3PosteriorNSurgeryRecovery
    Wang et al.201455/FNumbness in legsT6-T8PosteriorNSurgeryImproved
    da Costa et al.201443/MParaplegiaT9-T10PosteriorNSurgeryImproved
    Nakao et al.201432/FLeg numbness and paraparesisT1-T6PosteriorNSurgeryRecovery
    Nadi et al.201550/FBack pain and paraparesisT6-T9PosterolateralYSurgeryImproved
    Present case201565/FLBP and paraparesisT8-T10PosterolateralNSurgeryRecovery
    • M: male; F: female; LBP: low back pain; NR: not reported; N: no; Y: yes; RT: radiotherapy.

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Thoracic epidural spinal angiolipoma with coexisting lumbar spinal stenosis: Case report and review of the literature
Mario Benvenutti-Regato, Rafael De la Garza-Ramos, Enrique Caro-Osorio
International Journal of Spine Surgery Jan 2015, 9 67; DOI: 10.14444/2067

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Thoracic epidural spinal angiolipoma with coexisting lumbar spinal stenosis: Case report and review of the literature
Mario Benvenutti-Regato, Rafael De la Garza-Ramos, Enrique Caro-Osorio
International Journal of Spine Surgery Jan 2015, 9 67; DOI: 10.14444/2067
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