8-year-old, Neck Pain, Weak Limb

8-year-old male presented with neck pain and right upper limb weakness for two months.

Figure 1. Sagittal T1WI showed intradural extramedullary oval-shaped, well-defined hyperintense mass indenting the posterior aspect of the spinal cord extends from C2 to D1 level.

Figure 2. Sagittal T2WI showed hyper intensity of the mass.

Figure 3. MR myelography shows CSF concavity below the mass confirming its intradural location.

Figure 4. Axial T2WI show effaced spinal cord.

Figure 5. Sagittal post contrast showed mild heterogeneous enhancement.

Figure 6. Sagittal DWI showed decreased diffusivity of the mass, its ADC at (b=1000) was 0.43x10−3 mm2/s.

Diagnosis: Intradural extramedullary lipoma

Spinal cord lipomas are uncommon, accounting for approximately 1% of all spinal cord tumors.

The more common lipomatous malformations, associated with spinal dysraphism have been extensively reviewed in the literature.

Lipoma pathogenesis could be a result of a developmental error, in which lipoma can arise from inclusions of embryonic rests, within the meninges during the formation of the neural tube.

The low density of the fat tissue produces the pathognomonic appearance of lipoma on CT.