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J Neurol Surg A Cent Eur Neurosurg 2022; 83(02): 161-172
DOI: 10.1055/s-0041-1739217
Review Article

Thoracic Spinal Angiolipomas: A Systematic Review

Giuseppe Emmanuele Umana 
1   Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
,
Massimiliano Visocchi
2   Department of Neurosurgery, Policlinico Universitario Agostino Gemelli, Roma, Lazio, Italy
3   Catholic University of the Sacred Heart Rome Campus, Roma, Italy
,
Elena Roca
4   Department of Neurosurgery, Head and Neck Surgery, Poliambulanza Foundation Hospitals, Brescia, Lombardia, Italy
,
Maurizio Passanisi
5   Department of Neurosurgery, Azienda Ospedaliera Cannizzaro, Catania, Sicilia, Italy
,
Marco Fricia
1   Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
,
Maria Grazia Tranchina
6   Department of Pathological Anatomy, Cannizzaro Hospital, Catania, Sicilia, Italy
,
Santino Ottavio Tomasi
7   Department of Neurosurgery, Paracelsus Medical Private University, Salzburg, Austria
,
Giovanni Federico Nicoletti
8   Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy
,
Salvatore Cicero
1   Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
,
Gianluca Scalia 
8   Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy
› Author Affiliations Funding None.
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Abstract

Background Spinal angiolipomas (SAs) are rare, benign tumors, representing 0.0004 to 1.2% of angiolipomas, usually located at the extradural and posterior thoracic level, with multimetameric extension.

Methods A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched on PubMed and Scopus databases for published articles with the Mesh term “spinal angiolipoma” and pertinent associations. Language restriction to English papers was applied. The authors also reported three emblematic cases of patients who underwent surgical resection of spindle-shaped (type IA) and dumbbell-shaped (type II) SAs between 2014 and 2020.

Results Of the 256 retrieved articles, 33 were included in the meta-analysis. These 33 studies, together with our 3 reported cases, included a total of 60 patients, 36 females (60%) and 24 males (40%), with a mean age of 53.12 ± 12.82 years (range: 12–77 years).

T5 was the most represented level (22 patients). Usually, the localization of SA was extradural, with 53 patients suffering from spindle-shaped type IA SA (88.3%) and 7 patients from dumbbell-shaped type II SA (11.6%). Almost all patients underwent laminectomy (78.3%) and presented a full recovery of motor deficits (85%). Gross total removal (GTR) was performed in 93.3% of patients. The mean follow-up was of 22.71 ± 21.45 months (range: 2–80 months). There was no documented recurrence at follow-up magnetic resonance imaging in any of the patients.

Conclusions SAs are rare, benign tumors with a great vascular component that presents a favorable outcome. GTR is the gold standard treatment and usually an adjuvant therapy is not required. Even infiltrative lesions, which are more complex, can be treated successfully with a good prognosis. Dumbbell-shaped SAs must be differentiated from schwannomas and meningiomas, and require different surgical techniques, given the profuse bleeding associated with the attempt of debulking. En block resection is the key to treat these common benign tumors with acceptable blood loss.

Keywords

Spinal angiolipomas - tumor - paravertebral - costotransversectomy - laminectomy


Publication History

Received: 31 October 2020

Accepted: 14 May 2021

Article published online:
20 December 2021

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