Thoracic spine fracture associated with an extradural lipoma: Case report and systematic review of the literature

Abstract

Isolated extradural lipoma (IEL), not associated to spinal dysraphisms, is a rare condition. Frequently IEL was confused with much more frequent diffuse lipomatosis. The lesion can be completely asymptomatic and occasionally diagnosed with magnetic resonance (MR) imaging. This paper describes a case of a patient with an axial compression fracture of the thoracic spine associated with an extradural lipoma. We also performed a systematic review of the pertinent literature in order to retrieve the key information regarding: the diagnosis, the clinical features and the treatment. Introduction Isolated Extradural lipoma (IEL), not associated with spinal dysraphism, is a rare lesion accounting for 0.4-0.8% of all intraspinal tumors; however, the true incidence is not established and, probably, underestimated since extradural lipomas rarely cause clinical symptoms,1 on the other hand, many pathologies of the spine can cause non-specific symptoms such as low back pain.2-5 It is important to differentiate IEL from spinal epidural lipomatosis (SEL) which is instead a hyperplasia of epidural fat which rarely causes compression of the spinal nerve structures. In most cases SEL is associated with obesity, chronic steroid therapy or some endocrinopathies.1,6,7 Magnetic resonance (MR) imaging represent the reference standard for the IEL diagnosis.7,8 The aim of the study is to describe a case of a patient with an axial compression fracture of the thoracic spine associated with an IEL. We also performed a systematic review of the literature in order to retrieve the key information regarding: the diagnosis, the clinical features and the treatment.