Spinal cord lipomas are rare and benign tumors which may cause progressive neurological
deficits due to their local expansion. We present the case of a 59-year-old male patient
with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed
with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images
of the thoracic spine suggested a subacute intramedullary hematoma. Due to progression
of the neurological deficit, the patient was referred to a neurosurgeon, who indicated
surgical evacuation of the hematoma. The intraoperative finding revealed an intramedullary
spinal cord lipoma, which was later confirmed by histological analysis. Since subacute
intramedullary hematomas and intramedullary spinal cord lipomas present with similar
clinical and radiological features, diffusion-weighted MR imaging should be used to
distinguish these entities.
Key-words:
Diffusion-weighted imaging - intramedullary spinal cord lipoma - subacute intramedullary
hematoma
