Lumbosacral angiolipoma

CORRESPONDÊNCIA

Lumbosacral angiolipoma

Mehmet Turgut, MD

Department of Neurosurgery Adnan Menderes University Hospital TR-09020 Aydin, Turkey E-mail: [e-mail]

To the Editor - I throughly enjoyed the recent paper by Dr. Antonio Aversa do Souto et al.¹, regarding a ventral extradural angiolipoma at the lumbosacral level with erosion of the sacrum. Although they have documented nicely their unique case with a disc herniation associated with the tumor at the level of L4-L5 space, I felt obliged to contribute a few points: 1) the authors' statement that about 90 cases of spinal angiolipoma have been reported at the literature is not right, and to my knowledge a total of 100 cases have been reported before submission date of theirs article to the journal²; 2) another point that is not true in the article is the association of spinal angiolipoma and lumbar disc herniation in two previous reported cases by Nishiura et al.³ and Pagni and Canavero⁴, because the patients having only unusual tumoral lesions with pure lumbar anterior localization in these reports had been misdiagnosed as intervertebral disc herniation; 3) to the best of knowledge, such a case has never been previously described in the medical literature to date; 4) thus, it seems apparent that sciatic symptoms should also be added to the clinical presentation of pure spinal angiolipomas and MRI is the imaging modality of choice in the evaluation of these lesions.

REFERENCES

1. Souto AA, Domingues FS, Chimelli L, Lemos AM. Lumbosacral angiolipoma: case report. Arq Neuropsiquiatr 2003;61:269-273.

2. Turgut M. Spinal extradural angiolipoma, with a literature review. Childs Nerv Syst 2003 (in press).

3. Nishiura I, Kubo Y, Koyoana T. Spinal haemangiolipoma: three cases report. Neurochirurgia (Stuttg) 1986;29:63-66.

4. Pagni CA, Canavero S. Spinal epidural angiolipoma: rare or unreported? Neurosurgery 1992;31:758-764.

AUTHOR'S RESPONSE - I appreciate Turgut's comments regarding our article¹. His excellent review of spinal angiolipomas published previously² is going to be updated in a future publication. According to him, the number of reported cases reached 100, which is according with our thought that the number of angiolipomas being reported is rapidly growing with the advance of MRI. I agree with him that the association of angiolipoma and disc herniation in the cases published by Nishiura³ and Pagni⁴ were the consequence of preoperative misdiagnosis. I feel comfortable with his comments confirming how unique is the case we have published, and I hope it will contribute to the best understanding of this relatively unknown entity.

REFERENCES

1. Souto AA, Domingues FS, Chimelli L, Lemos AM. Lumbosacral angiolipoma: case report. Arq Neuropsiquiatr 2003;61:269-273.

2. Turgut M. Spinal angiolipomas: report of a case and review of the cases published since the discovery of the tumor in 1890. Br J Neurosurg 1999;13:20-40.

3. Nishiura I, Kubo Y, Koyama T. Spinal hemangiolipoma: three cases report. Neurochirurgia (Stuttg) 1986;29:63-66.

4. Pagni CA, Canavero S. Spinal epidural angiolipoma: rare or unreported: Neurosurgery 1992;31:758-764.

Antonio Aversa do Souto, MD

Publication Dates

• Publication in this collection
  30 Apr 2004
• Date of issue
  Mar 2004