Intramedullary lipoma mimicking syringomyelia: a case report and literature review

Background: Intramedullary lipomas can be misdiagnosed as syringomyelia. We reported a case of intramedullary lipoma similar to syringomyelia and review the literature. Case presentation A 35-year-old woman was admitted due to hypoesthesia in the right limb, especially the lower extremity. Spinal magnetic resonance imaging (MRI) revealed L2-3 and C5-T7 lesions, with hyperintensity in T1-weighted and T2-weighted images, and hypointensity in T1 fat suppression-weighted images. The cervicothoracic lesion was considered to be a lipoma and was observed without surgery, while the lumbosacral lesion was removed, and the pathological results indicated cholesteatoma. The neurological function of the patient's lower limbs improved one month after surgery. Conclusion The pre-operative differentiation between intramedullary lipoma and syringomyelia requires special caution.