Acute paraplegia by spinal angiolipoma. Case report and literature review

Spinal angiolipoma is an uncommon form of benign tumor. There are 142 reported cases and only one of acute paraplegia. We describe a case of a 39 year old male with acute spinal paraplegia angiolipoma in T4-T5 with surgical resolution three weeks after the onset of the neurological syndrome. Postoperative neurologic recovery was complete. The angiolipoma consists of mature fat cells and abnormal blood vessels. There are 2 types: non-infiltrating and infiltrating. Its clinical course is slow and progressive, it can be accelerated by vascular phenomena, intratumoral abscess, and pregnancy. There is just one report of spontaneous intratumoral hemorrhage and acute paraplegia, coinciding with our case. There is no consensus as to treatment, and release and complete resection are suggested, as it is a disease with good prognosis. Angiolipoma spinal epidural is a rare form of benign tumor, and the treatment of this pathology continues to be release and resection of the tumor, with a favorable prognosis, despite the delay in surgery, as in the case reported. Intratumoral bleeding should be considered a cause of acute spinal compression syndrome, as ocurred in our patient.

脊髓血管脂肪瘤（Spinal angiolipoma）是一类少见的良性肿瘤。目前已报道142例病例，其中仅1例合并急性截瘫（acute paraplegia）。本文报告1例39岁男性患者，其T4-T5节段脊髓血管脂肪瘤引发急性脊髓截瘫，患者于神经系统症状发作3周后接受手术治疗，术后神经功能完全恢复。该肿瘤由成熟脂肪细胞与异常血管组织构成，可分为非浸润型与浸润型两种亚型。其临床病程多呈缓慢进展性，血管事件、瘤内脓肿及妊娠状态可加速病情进展。目前仅见1例自发性瘤内出血伴急性截瘫的报道，与本例患者的发病情况相符。目前针对该病尚无统一治疗共识，临床建议行肿瘤松解联合完整切除，因该疾病整体预后良好。脊髓硬膜外血管脂肪瘤（spinal epidural angiolipoma）是一类罕见的良性肿瘤，尽管手术可能存在延迟，但采用肿瘤松解与切除的治疗方案仍可获得良好预后，本例报告即印证了这一点。瘤内出血应被视为急性脊髓压迫综合征的潜在诱因之一，本例患者的发病过程即符合这一情况。