Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Scrotal Pearls
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Lipomyelocele

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
Adobe32 PDF Imagej32 ImageJA

History

5 month old with midline skin cleft.


Case Images


Diagnosis

Lipomyelocele

Findings

MR – Sagittal T1 and axial T2 images of the lumbosacral spine demonstrate 1) dermal sinus tract extending into the spinal canal, 2) large infiltrative intraspinal lipoma dorsal to a dysplastic neural placode, 3) tethered neural placode at the lumbosacral junction and 4) lumbosacral dysrhaphism.

Discussion

Lipomyeloceles are a skin covered dysraphic congenital abnormality of the spine. Lipomas extend from the subcutaneous soft tissues into the spinal canal through a dysraphic defect and are adherent to the dorsal aspect of the spinal cord/neural placode. Patients may present with a soft subcutaneous lumbosacral mass, bladder or bowel dysfunction, lower extremity weakness and/or lower extremity orthopedic anomalies.

Tethering is invariably present. The thecal sac is focally enlarged at the level of dysraphism. The subarachnoid space anterior to the spinal cord/placode is normal. The dorsal surface of the placode has no ependymal lining and is immediately adjacent to the lipoma. The extent of the lipoma is not confined to the levels of dysraphism.

Associated abnormalities are common and include segmentation and reduction defects of the spine(butterfly vertebrae and caudal regression), gastrointestional anomalies (imperforate anus, anal stenosis, and anal malposition), and genitourinary malformations.

Reference

Barkovich AJ. Pediatric Neuroimaging, 4th Ed. Lippincott, Williams and Wilkins (2005).



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare