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Background <p>Non-dysraphic intramedullary lipomas (NDIL) are rare spinal cord tumors that lack spinal dysraphism features, presenting diagnostic and therapeutic challenges. We report a case of a 2-month-old male with a cervicothoracic intramedullary lipoma. </p> <p>Case presentation</p> <p>He presented with rapid-onset of upper limb plegia. MRI revealed an intramedullary cervicothoracic lesion with hyperintensity on both T1 and T2-weighted images and fat suppression on STIR sequences, compatible with an intramedullary lipoma. Due to the rapid progression of neurological deficits, surgical decompression was performed. Intraoperative neurophysiological monitoring was used to optimize neurological safety. A subtotal resection of the lipoma was performed with preservation of neurological function. Postoperative MRI confirmed a reduction in lesion size, and early motor recovery was noted, allowing the child to achieve functional mobility by the time of discharge. At the 2-year follow-up, the patient exhibited near-complete recovery, with only mild residual paresis. </p> Conclusion <p>NDIL, though rare, can lead to significant neurological compromise. Early surgical intervention with subtotal resection and neuromonitoring is effective for decompression while minimizing neurological risks. Long-term follow-up is essential to monitor for recurrence or growth. This case underscores the importance of timely diagnosis and management to prevent irreversible neurological deficits in patients with NDIL.</p>

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Non-dysraphic intramedullary lipoma: a case report and review of literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月18日

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  • João Nogueira,
  • João Meira,
  • Josué Pereira,
  • Paulo Pereira

摘要

Background

Non-dysraphic intramedullary lipomas (NDIL) are rare spinal cord tumors that lack spinal dysraphism features, presenting diagnostic and therapeutic challenges. We report a case of a 2-month-old male with a cervicothoracic intramedullary lipoma.

Case presentation

He presented with rapid-onset of upper limb plegia. MRI revealed an intramedullary cervicothoracic lesion with hyperintensity on both T1 and T2-weighted images and fat suppression on STIR sequences, compatible with an intramedullary lipoma. Due to the rapid progression of neurological deficits, surgical decompression was performed. Intraoperative neurophysiological monitoring was used to optimize neurological safety. A subtotal resection of the lipoma was performed with preservation of neurological function. Postoperative MRI confirmed a reduction in lesion size, and early motor recovery was noted, allowing the child to achieve functional mobility by the time of discharge. At the 2-year follow-up, the patient exhibited near-complete recovery, with only mild residual paresis.

Conclusion

NDIL, though rare, can lead to significant neurological compromise. Early surgical intervention with subtotal resection and neuromonitoring is effective for decompression while minimizing neurological risks. Long-term follow-up is essential to monitor for recurrence or growth. This case underscores the importance of timely diagnosis and management to prevent irreversible neurological deficits in patients with NDIL.