Rapid deterioration of an asymptomatic lumbosacral lipoma due to formation of an extracanalicular syrinx: case report

Yumiko Komori MD, Masahiro Nonaka MD, PhD, Takamasa Kamei MD, Junichi Takeda MD, Tetsuo Hashiba MD, PhD, Kunikazu Yoshimura MD, PhD, and Akio Asai MD, PhD
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  • Department of Neurosurgery, Kansai Medical University, Osaka, Japan
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The authors present the case of a 1-month-old girl with a lumbosacral lipoma who then developed an extracanalicular syrinx and experienced rapid deterioration. The patient’s initial MRI study, obtained before she became symptomatic, revealed a spinal lipoma with a syrinx in contact with the lipoma-cord interface. She was initially asymptomatic but developed loss of motor function in the left leg 14 days after MRI. Emergency surgery was performed. Intraoperative findings revealed a swollen spinal cord. Lipomatous tissue on the caudal side of the conus was removed subtotally, and the central canal was opened. Expansion of the syrinx was observed intraoperatively. Postoperatively, the patient’s left leg paresis remained. Postoperative MRI revealed rostral and extracanalicular expansion of the syrinx. This is the first report on the rapid deterioration of a conus lipoma due to extracanalicular expansion of a syrinx. Careful follow-up and repeat MRI should be considered for patients with spinal lipomas with syringomyelia, especially when the syrinx is attached to the lipoma-cord interface.

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Contributor Notes

Correspondence Masahiro Nonaka: Kansai Medical University, Osaka, Japan. nonakamasa65@gmail.com.

INCLUDE WHEN CITING Published online December 25, 2020; DOI: 10.3171/2020.7.PEDS20512.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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