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094. A Case Series Describing Cervical and/or Thoracic Intramedullary Lipomas

Authors: Austin Sellers

Introduction:
Spinal cord lipomas account for approximately 1% of all spinal cord tumors. Within this group, non-conus intramedullary lipomas are a rare subset. A paucity of research exists in describing intramedullary lipomas confined to the cervical or thoracic region. The relevant body of literature is comprised of scattered case reports, the largest set of pediatric patients reported on is 5. We aim to further characterize a set of pediatric patients at 2 hospitals, all of whom have been diagnosed with intramedullary cervical/thoracic lipoma.Methods: A database of more than 300 neurosurgical patients presenting with intramedullary spinal cord tumors was maintained at Johns Hopkins Hospital and Johns Hopkins All Children’s Hospital on patients treated from 1994 through 2021. Cases were identified using diagnostic codes and confirmed based on electronic health record (EHR). Demographic, surgical, and outcome data were collected via manual chart review.
Results:
A total of 17 pediatric cases were identified, and confirmed via pathology, as having lipomas. Of these, 12 were confirmed as intramedullary, and of these only 3 were confined to the cervical/thoracic regions. All patients underwent elective laminoplasty with 2 undergoing subsequent surgical debulking. The average age of these patients was 10.3 years (range 9 to 13), including 1 male and 2 female patients. Patients underwent routine follow-up (Range: 0 months – 11 years) and (1) saw recurrence of their tumor. Two of these patients returned to the operating room, one for subsequent resection, the other for removal of hardware.
Conclusion:
While intramedullary cervical/thoracic lipomas remain a rare subset of spinal cord tumors, they often result in progressive and debilitating disease courses. Given the relative lack of information on such tumors, this study helps to provide further characterization of cases. Future studies are warranted to inform clinical suspicion, detection, and management of patients presenting with these tumors.