27 days male child presenting with subcutaneous swelling over lower back region
Findings
- Sagittal, axial T1 and T2 weighted MR images of lumbosacral spine reveals a subcutaneous fatty mass in lumbosacral region extending into intradural location of spinal canal through spina bifida with neural placode-lipoma interferace within the spinal canal.
- Low lying spinal cord is seen with conus medullaris ending at L4 vertebra and posterior tethering of spinal cord to intradural lipoma.
Diagnosis
Closed spinal dysraphism; Lipomyelocele with tethered cord syndrome
Summary
Lipomyelocele and lipomyelomeningocele present clinically as subcutaneous fatty mass. The main differentiating feature between a lipomyelocele and lipomyelomeningocele is the position of the placode–lipoma interface. With a lipomyelocele, the placode–lipoma interface lies within the spinal canal. With a lipomyelomeningocele, the placode–lipoma interface lies outside of the spinal canal due to expansion of the subarachnoid space. Closed spinal dysraphisms with spinal lipomas are the most common causes of tethered cord syndrome.
Further reads
Rufener, S. L., Ibrahim, M., Raybaud, C. A., & Parmar, H. A. (2010). Congenital spine and spinal cord malformations–pictorial review. AJR. American journal of roentgenology, 194(3 Suppl), S26–S37. https://doi.org/10.2214/AJR.07.7141
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