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Spine
Diagnosis
Congenital
Abnormalities of Neurulation
Lipoma
Lipoma
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Intradural (juxtamedullary, subpial) or terminal lipoma

              • Definitions

                • Spinal lipoma intimately associated with spinal cord (intradural) or distal cord/filum insertion (terminal)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Pang D: Surgical management of complex spinal cord lipomas: how, why, and when to operate. a review. J Neurosurg Pediatr. 23(5):537-56, 2019
                                                  2. Rhodes RH: Congenital spinal lipomatous malformations. part 1. spinal lipomas, lipomyeloceles, and lipomyelomeningoceles. Fetal Pediatr Pathol. 1-52, 2019
                                                  3. Jones V et al: The pathology of lumbosacral lipomas: macroscopic and microscopic disparity have implications for embryogenesis and mode of clinical deterioration. Histopathology. 72(7):1136-44, 2018
                                                  4. Seki T et al: Surgical outcomes of pediatric patients with asymptomatic tethered cord syndrome. Asian Spine J. 12(3):551-5, 2018
                                                  5. Morioka T et al: Neurosurgical management and pathology of lumbosacral lipomas with tethered cord. Neuropathology. 37(5):385-92, 2017
                                                  6. Morota N et al: New classification of spinal lipomas based on embryonic stage. J Neurosurg Pediatr. 19(4):428-39, 2017
                                                  7. Severino R et al: Cervical intramedullary spinal cord lipoma. Surg Neurol Int. 8:255, 2017
                                                  8. Cools MJ et al: Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr. 13(5):559-67, 2014
                                                  9. Harada A et al: Intraspinal lesions associated with sacrococcygeal dimples. J Neurosurg Pediatr. 14(1):81-6, 2014
                                                  10. Horrion J et al: Adult intradural lipoma with tethered spinal cord syndrome. JBR-BTR. 97(2):121, 2014
                                                  11. Kole MJ et al: Currarino syndrome and spinal dysraphism. J Neurosurg Pediatr. 13(6):685-9, 2014
                                                  12. Scottoni F et al: Spinal ultrasound in patients with anorectal malformations: is this the end of an era? Pediatr Surg Int. 30(8):829-31, 2014
                                                  13. Borg H et al: Impact of spinal cord malformation on bladder function in children with anorectal malformations. J Pediatr Surg. 44(9):1778-85, 2009
                                                  14. Muthukumar N: Congenital spinal lipomatous malformations: part I--classification. Acta Neurochir (Wien). 151(3):179-88; discussion 197, 2009
                                                  15. Muthukumar N: Congenital spinal lipomatous malformations: part II--clinical presentation, operative findings, and outcome. Acta Neurochir (Wien). 151(3):189-97; discussion 197, 2009
                                                  16. Oi S et al: Embryopathogenetic surgicoanatomical classification of dysraphism and surgical outcome of spinal lipoma: a nationwide multicenter cooperative study in Japan. J Neurosurg Pediatr. 3(5):412-9, 2009
                                                  17. Pang D et al: Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode: part I-surgical technique. Neurosurgery. 65(3):511-28; discussion 528-9, 2009
                                                  18. Samuels R et al: Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty. Childs Nerv Syst. 25(9):1085-9, 2009
                                                  19. Koyanagi I et al: Radiological findings and clinical course of conus lipoma: implications for surgical treatment. Neurosurgery. 63(3):546-51; discussion 551-2, 2008
                                                  20. Torre M et al: Long-term urologic outcome in patients with caudal regression syndrome, compared with meningomyelocele and spinal cord lipoma. J Pediatr Surg. 43(3):530-3, 2008
                                                  21. Finn MA et al: Spinal lipomas: clinical spectrum, embryology, and treatment. Neurosurg Focus. 23(2):1-12, 2007
                                                  22. Arai H et al: Surgical experience of 120 patients with lumbosacral lipomas. Acta Neurochir (Wien). 143(9):857-64, 2001
                                                  23. Bulsara KR et al: Clinical outcome differences for lipomyelomeningoceles, intraspinal lipomas, and lipomas of the filum terminale. Neurosurg Rev. 24(4):192-4, 2001
                                                  24. Tortori-Donati P et al: Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging. 12(6):375-409, 2001
                                                  25. van Leeuwen R et al: Surgery in adults with tethered cord syndrome: outcome study with independent clinical review. J Neurosurg. 94(2 Suppl):205-9, 2001
                                                  26. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000
                                                  27. Endoh M et al: Spontaneous shrinkage of lumbosacral lipoma in conjunction with a general decrease in body fat: case report. Neurosurgery. 43(1):150-1; discussion 151-2, 1998
                                                  28. Iskandar BJ et al: Congenital tethered spinal cord syndrome in adults. J Neurosurg. 88(6):958-61, 1998
                                                  29. Byrne RW et al: Operative resection of 100 spinal lipomas in infants less than 1 year of age. Pediatr Neurosurg. 23(4):182-6; discussion 186-7, 1995
                                                  30. Fujiwara F et al: Intradural spinal lipomas not associated with spinal dysraphism: a report of four cases. Neurosurgery. 37(6):1212-5, 1995
                                                  31. Aoki N: Rapid growth of intraspinal lipoma demonstrated by magnetic resonance imaging. Surg Neurol. 34(2):107-10, 1990
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Intradural (juxtamedullary, subpial) or terminal lipoma

                                                              • Definitions

                                                                • Spinal lipoma intimately associated with spinal cord (intradural) or distal cord/filum insertion (terminal)

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nonvascular Interventions

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Pang D: Surgical management of complex spinal cord lipomas: how, why, and when to operate. a review. J Neurosurg Pediatr. 23(5):537-56, 2019
                                                                                                  2. Rhodes RH: Congenital spinal lipomatous malformations. part 1. spinal lipomas, lipomyeloceles, and lipomyelomeningoceles. Fetal Pediatr Pathol. 1-52, 2019
                                                                                                  3. Jones V et al: The pathology of lumbosacral lipomas: macroscopic and microscopic disparity have implications for embryogenesis and mode of clinical deterioration. Histopathology. 72(7):1136-44, 2018
                                                                                                  4. Seki T et al: Surgical outcomes of pediatric patients with asymptomatic tethered cord syndrome. Asian Spine J. 12(3):551-5, 2018
                                                                                                  5. Morioka T et al: Neurosurgical management and pathology of lumbosacral lipomas with tethered cord. Neuropathology. 37(5):385-92, 2017
                                                                                                  6. Morota N et al: New classification of spinal lipomas based on embryonic stage. J Neurosurg Pediatr. 19(4):428-39, 2017
                                                                                                  7. Severino R et al: Cervical intramedullary spinal cord lipoma. Surg Neurol Int. 8:255, 2017
                                                                                                  8. Cools MJ et al: Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr. 13(5):559-67, 2014
                                                                                                  9. Harada A et al: Intraspinal lesions associated with sacrococcygeal dimples. J Neurosurg Pediatr. 14(1):81-6, 2014
                                                                                                  10. Horrion J et al: Adult intradural lipoma with tethered spinal cord syndrome. JBR-BTR. 97(2):121, 2014
                                                                                                  11. Kole MJ et al: Currarino syndrome and spinal dysraphism. J Neurosurg Pediatr. 13(6):685-9, 2014
                                                                                                  12. Scottoni F et al: Spinal ultrasound in patients with anorectal malformations: is this the end of an era? Pediatr Surg Int. 30(8):829-31, 2014
                                                                                                  13. Borg H et al: Impact of spinal cord malformation on bladder function in children with anorectal malformations. J Pediatr Surg. 44(9):1778-85, 2009
                                                                                                  14. Muthukumar N: Congenital spinal lipomatous malformations: part I--classification. Acta Neurochir (Wien). 151(3):179-88; discussion 197, 2009
                                                                                                  15. Muthukumar N: Congenital spinal lipomatous malformations: part II--clinical presentation, operative findings, and outcome. Acta Neurochir (Wien). 151(3):189-97; discussion 197, 2009
                                                                                                  16. Oi S et al: Embryopathogenetic surgicoanatomical classification of dysraphism and surgical outcome of spinal lipoma: a nationwide multicenter cooperative study in Japan. J Neurosurg Pediatr. 3(5):412-9, 2009
                                                                                                  17. Pang D et al: Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode: part I-surgical technique. Neurosurgery. 65(3):511-28; discussion 528-9, 2009
                                                                                                  18. Samuels R et al: Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty. Childs Nerv Syst. 25(9):1085-9, 2009
                                                                                                  19. Koyanagi I et al: Radiological findings and clinical course of conus lipoma: implications for surgical treatment. Neurosurgery. 63(3):546-51; discussion 551-2, 2008
                                                                                                  20. Torre M et al: Long-term urologic outcome in patients with caudal regression syndrome, compared with meningomyelocele and spinal cord lipoma. J Pediatr Surg. 43(3):530-3, 2008
                                                                                                  21. Finn MA et al: Spinal lipomas: clinical spectrum, embryology, and treatment. Neurosurg Focus. 23(2):1-12, 2007
                                                                                                  22. Arai H et al: Surgical experience of 120 patients with lumbosacral lipomas. Acta Neurochir (Wien). 143(9):857-64, 2001
                                                                                                  23. Bulsara KR et al: Clinical outcome differences for lipomyelomeningoceles, intraspinal lipomas, and lipomas of the filum terminale. Neurosurg Rev. 24(4):192-4, 2001
                                                                                                  24. Tortori-Donati P et al: Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging. 12(6):375-409, 2001
                                                                                                  25. van Leeuwen R et al: Surgery in adults with tethered cord syndrome: outcome study with independent clinical review. J Neurosurg. 94(2 Suppl):205-9, 2001
                                                                                                  26. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000
                                                                                                  27. Endoh M et al: Spontaneous shrinkage of lumbosacral lipoma in conjunction with a general decrease in body fat: case report. Neurosurgery. 43(1):150-1; discussion 151-2, 1998
                                                                                                  28. Iskandar BJ et al: Congenital tethered spinal cord syndrome in adults. J Neurosurg. 88(6):958-61, 1998
                                                                                                  29. Byrne RW et al: Operative resection of 100 spinal lipomas in infants less than 1 year of age. Pediatr Neurosurg. 23(4):182-6; discussion 186-7, 1995
                                                                                                  30. Fujiwara F et al: Intradural spinal lipomas not associated with spinal dysraphism: a report of four cases. Neurosurgery. 37(6):1212-5, 1995
                                                                                                  31. Aoki N: Rapid growth of intraspinal lipoma demonstrated by magnetic resonance imaging. Surg Neurol. 34(2):107-10, 1990
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