Spinal Angiolipoma: A Rare Cause of Spinal Cord Compression

Spinal angiolipomas (SALs) are uncommon benign tumors composed of mature adipocytes and abnormal blood vessels, with symptoms usually appearing gradually due to the progressive compression of the spinal cord. In this context, we report the case of a 34-year-old female patient with no significant medical history who presented with heaviness in both lower limbs and difficulty walking for the past six months. MRI showed an epidural posterior lesion extending from the first to the sixth thoracic vertebrae, strongly compressing the spinal cord, and surgical intervention for spinal cord decompression and total resection of the lesion was performed successfully. Histological examination revealed a lobulated lesion composed of two components: vascular and adipose, confirming the diagnosis. As SALs are rare benign tumors of the spinal cord characterized by a mixed proliferation of mature adipose tissue and abnormal vascular structures, their exact incidence remains unknown, although literature suggests a male predominance and a peak occurrence in adulthood. Clinical manifestations are typically progressive and depend on the level of spinal cord compression, making MRI the key diagnostic tool. Since treatment is primarily based on decompressive surgery, early diagnosis and intervention are essential. Although rare, SALs can be potentially debilitating due to their progressive compressive effects; therefore, MRI allows for a reliable diagnosis, and management relies on appropriate surgical excision. Long-term follow-up is crucial to prevent neurological complications.