Adult cervicothoracic subpial fibrolipoma without dysraphism: An extremely rare case report

• Published in: International journal of surgery case reports Vol. 109; p. 108616
• Main Authors: Adhimarta, Willy, Islam, Andi Asadul, Kurniawan, Venansius Ratno, Otniel, James, Faruk, Muhammad
• Format: Report
• Language: English
• Published: 01.08.2023
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.108616

INTRODUCTIONSpinal tumors constitute 15 % of all tumors in the central nervous system. Pain is often the initial symptom, which can be localized, nocturnal, or radiated to the arms and/or limbs. We report a rare case with a subpial lipoma in the cervicothoracic spine and review the current literature. CASE PRESENTATIONA 22-year-old female presented with the chief complaint of tetraparesis for three months before admission. Magnetic resonance imaging revealed an intradural tumor on the fifth cervical to fourth thoracic vertebrae. She underwent a laminectomy to remove the tumor completely. Histopathological examination revealed a proliferation of mature fat cells amongst fibrous connective tissue. Surrounding nerve fibers and erythrocyte-filled blood vessels were also found, suggesting a subpial fibrolipoma. Postoperatively, there was an improvement in muscle strength six weeks after surgery. Motoric strength was grade 5 for the upper extremities and grade 4 for the lower extremities. DISCUSSIONIn this patient, cervicothoracic laminectomy and tumor removal were performed without instrumentation. Total tumor resection is the primary goal when removing a pathological lesion. However, this depends on the lesion's adhesion to the surrounding tissue. Therefore, partial tumor resection may be possible, given the neurological complications that can occur. CONCLUSIONBecause subpial lipomas are rare, their treatment is highly specialized. An assessment of the patient's physical condition and imaging assessments can provide information about potential treatment strategies and outcomes.