THORACIC EPIDURAL LIPOMATOSIS INDUCED BY STEROID-THERAPY - A NEW CASE DOCUMENTED BY MAGNETIC-RESONANCE-IMAGING

A new case of epidural lipomatosis induced by long-term corticosteroid therapy for pain due to multiple fractures in a 35-year-old male is reported. The unusual feature of this case was the large size of the lesion, which extended from T2 to T12. Signs and symptoms were those of spinal cord compression with paraparesia. CT scan and magnetic resonance imaging findings enabled preoperative diagnosis of epidural lipomatosis and evaluation of the number of vertebral levels involved. Although a very small number of idiopathic cases have been reported, epidural lipomatosis is usually due to protracted corticosteroid therapy. A review of the literature found 37 additional cases of which only five were documented by magnetic resonance imaging, which seems to be the investigation of choice. Lastly, although conservative treatment has been occasionally advocated, surgery is usually required and is successful in most instances.