1-year-old infant

 

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

 

Case Section

Pediatric Radiology

 

Patient's Information

Gender : Male
Age : 1

 

Clinical Summary

1-year-old infant

 

Imaging Findings

MR imaging demonstrates an oval-shape mass lies adjacent to the conus and extends through the segmental defect of L5 and S1 vertebral bodies.The mentioned-mass is high signal on T1- and T2-weighted images and shows signal loss on fat-suppression sequences,suggestive of intraspinal lipoma.Syrinx(Hydromyelia) involving the lower cord and conus.Conus terminates at the level of L4,indicating cord tethering.

 

Differential Diagnosis

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Final Diagnosis

Occult spinal dysraphism(Intraspinal lipoma)

 

Discussion (Related Text)

Intraspinal lipomas are classified as lipomyelocele/lipomyelomeningocele, fibrolipoma of the filum terminale, and intradural lipoma. Neurologic symptoms include sensory deficits, paresis, and bowel/bladder dysfunction. Premature separation of the superficial ectoderm from the neural ectoderm results in mesenchymal infiltration which differentiates into fat. In lipomyelocele/lipomyelomeningocele, the lipoma lies adjacent to the dysplastic spinal cord and extends into the spinal cord causing tethering. The lipoma is continuous with the subcutaneous fat and covered by intact skin. Lipomyelocele is always associated with spina bifida and often associated with segmentation anomalies of the vertebraeIn hydromyelia, there is dilatation of the central canal of the spinal cord. In syringomyelia and syringobulbia, there is dissection through the ependymal lining of the central canal and a CSF collection within the cord itself.

 

References

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