• Miguel Sáez-Alegre, Pérez López Carlos C Hospital La Paz, Madrid, Spain., Giner García Javier J Hospital La Paz, Madrid, Spain., Junnior Palpán Flores Alexis A Hospital La Paz, Madrid, Spain., García Feijoo Pablo P Hospital La Paz, Madrid, Spain., Vivancos Sánchez Catalina C Hospital La Paz, Madrid, Spain., and Isla Guerrero Alberto A Hospital La Paz, Madrid, Spain..
• Hospital La Paz, Madrid, Spain. Electronic address: miksaezalegre@gmail.com.
• World Neurosurg. 2019 Sep 1; 129: 341-344.

BackgroundWe review 2 previously published cases of epidural lipomatosis associated with syringomyelia. We also present the case of a 42-year-old woman with a medullary syrinx from C1 to T3, initially only with upper limb paresthesias that presented after 10 years of follow-up for left hemiparesis and paresthesias in the tongue. Chiari malformation and cerebral or spinal space-occupying lesions were ruled out, as were other causes of syrinx except the presence of epidural lipomatosis extending from T1 to T12.Case DescriptionRight laminotomies were performed from T1 to T12, removing excessive epidural fat tissue. After surgery the symptoms remained stable. At discharge the patient progressively recovered from the hemiparesis, and in follow-up magnetic resonance imaging the resolution of the syrinx was confirmed.ConclusionsThis is the third case of a patient with a spinal syrinx and no other related causes except from spinal lipomatosis, although with only 3 cases it is not possible to completely state that lipomatosis caused the syrinx. Our case supports the trend established by the 2 previous cases. For treatment, initially patients should be managed conservatively, trying to correct the underlying etiologies of spinal lipomatosis. In case of failed conservative treatment, removal of adipose epidural excess in the most appropriate way is preferred.Copyright © 2019 Elsevier Inc. All rights reserved.

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