|Title : Case 596|
Age / Sex : 0 / F
no clinical information (including age, sex, and chief complaint)
Fatty mass is continuous with the adjacdent subcutaneous fat
Closed spinal dyraphism
Congenital spinal lipomatous malformations
Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. On the basis of presence or absence of overlying skin covering, spinal dysraphism is divided into open and closed types. In an open spinal dysraphism, there is a defect in the overlying skin, and the neural tissue is exposed to the environment. In a closed spinal dysraphism, the neural tissue is covered by skin.
Closed spinal dysraphism CSD can be further divided based on the presence or absence of associated subcutaneous mass.
Closed spinal dysraphisms
Lipomyeloceles and lipomyelomeningoceles is a spinal canal lipoma with deect and is a kind of closed spinal dysraphism with subcutaneous mass. These abnormalities result from defective primary neurulation where there is premature focal disjunction of cutaneous ectoderm and neuroectoderm allowing mesenchyme to enter the neural tube. This mesenchyme later forms the lipomatous tissue for unknown reasons.
The main differentiating feature between 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 sub-arachnoid space. In both cases, syringomyelia is a commonly associated finding. Lipomyelocele and lipomyelomeningocele account for 20–56% of occult spinal dysraphism and 20% of skin-covered lumbosacral masses.
Acta Neurochir (Wien). 2009 Mar;151(3):179-188
|Total applicants||37||Correct answers||14|