Microsurgical treatment for spinal epidural angiolipomas

Acta Neurol Belg. 2021 Apr;121(2):421-427. doi: 10.1007/s13760-019-01192-6. Epub 2019 Jul 15.

Abstract

Spinal epidural angiolipomas are rare lesions composed of mature lipomatous and angiomatous elements. In this paper, the authors review a surgical series of ten patients with epidural angiolipomas. All patients had performed preoperative and postoperative magnetic resonance imaging. The diagnosis of angiolipoma was based on pathology. All the follow-up data were obtained during office visits. There were 5 males and 5 females with a mean age of 53.6 years. One tumor was located in the cervicothoracic, six in the thoracic, and three in the lumbar spine. The most common symptom was progressive motor deficit. Gross total resection of the tumor was achieved in nine cases, and subtotal resection was obtained in one case. No recurrence or regrowth of the residual tumor was observed during a follow-up period of 50.8 months. At the last follow-up, 90% of patients experienced improvement in the neurological function. Epidural angiolipomas are benign but clinically progressive lesions. Early surgery should be performed to prevent irreversible neurological deficits. Postoperative radiotherapy is not recommended. The risk of long-term recurrence/regrowth of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected.

Keywords: Angiolipoma; Long-term outcome; Neuroimaging; Spinal epidural tumor; Surgical resection.

MeSH terms

  • Adult
  • Aged
  • Angiolipoma / diagnostic imaging
  • Angiolipoma / surgery*
  • Epidural Space / diagnostic imaging
  • Epidural Space / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / surgery*
  • Treatment Outcome