Angiolipoma involving the spine: a report of two cases and a review of the literature

Angiolipoma of the spinal column is a lesion made up of mature adipocytes with abnormal blood vessels. Around 60 cases have been reported, the majority located in the extradural space, predominantly the dorsal area. We report two cases examined in our hospital by means of plain X ray, computed tomography and magnetic resonance (MR) imaging. We review the literature and the findings with the different imaging techniques, stressing the importance of the use of MR, especially those techniques involving fat suppression, in the preoperative diagnosis of these lesions. In general, they present high signal intensity on T1-weighted images, with some areas of iso/hyposignal in the interior, a finding that differentiates them from lipomatosis, a condition that presents high signal intensify on T1-weighted sequences, but homogeneously. The administration of a paramagnetic contrast agent enhanced the images, but to a lesser extent in lesions with very high signal intensity on T1-weighted images. The signal intensity can be variable or high on T2-weighted sequences. Techniques using fat suppression are especially specific since they enhance the non-lipomatous (angiomatous) component of the lesion. The association of these MR findings with adjacent skeletal changes, consisting of progressive spinal cord compression, should lead to a suspicion of this un-common lesion, which is successfully managed with surgery. (Author) 14 refs