Sudden onset of paraplegia caused by hemorrhagic spinal epidural angiolipoma. A case report

Eur Spine J. 2008 Sep;17 Suppl 2(Suppl 2):S296-8. doi: 10.1007/s00586-008-0591-3. Epub 2008 Jan 29.


Spinal epidural angiolipoma is a rare benign tumor containing vascular and mature adipose elements. A slow progressive clinical course was mostly presented and rarely a fluctuating course during pregnancy. The authors report the original case of spontaneous spinal epidural bleeding resulting from thoracic epidural angiolipoma who presented with hyperacute onset of paraplegia, simulating an extradural hematoma. The patient was admitted with sudden non-traumatic hyperacute paraplegia during a prolonged walk. Neurologic examination showed sensory loss below T6 and bladder disturbances. Spinal MRI revealed a non-enhanced heterogeneous thoracic epidural lesion, extending from T2 to T3. A bilateral T2-T4 laminectomy was performed to achieve resection of a lipomatous tumor containing area of spontaneous hemorrhage. The postoperative course was uneventful with complete neurologic recovery. Histologic examination revealed the tumor as an angiolipoma. Because the prognosis after rapid surgical management of this lesion is favorable, the diagnosis of spinal angiolipoma with bleeding should be considered in the differential diagnosis of hyperacute spinal cord compression.

Publication types

  • Case Reports

MeSH terms

  • Angiolipoma / complications*
  • Angiolipoma / pathology
  • Angiolipoma / physiopathology
  • Back Pain / etiology
  • Decompression, Surgical
  • Diagnosis, Differential
  • Disease Progression
  • Epidural Space / pathology
  • Epidural Space / physiopathology
  • Hematoma, Epidural, Spinal / etiology*
  • Hematoma, Epidural, Spinal / pathology
  • Hematoma, Epidural, Spinal / physiopathology
  • Hemorrhage / complications*
  • Hemorrhage / pathology
  • Hemorrhage / physiopathology
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paraplegia / etiology*
  • Paraplegia / pathology
  • Paraplegia / physiopathology
  • Spinal Cord / pathology
  • Spinal Cord / physiopathology
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / physiopathology
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / physiopathology
  • Spine / pathology
  • Spine / physiopathology
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / physiopathology
  • Treatment Outcome