Lipomyelomeningocele in a neonate: A case report from Eastern Nepal

Abstract Introduction: Myelomeningocele is a congenital neural tube defects associated with significant morbidity and mortality. Accounting for more than 80% of all neural defects, this condition requires immediate attention. In this case report, we present a 44-day old male child with the features of lipomyelomeningocele presented to our neurosurgery OPD. Case presentation: A 44-day old male child presented to the pediatric outpatient with complains of a gradually increasing swelling in the lumbar region since birth. The baby was referred to the Neurosurgery outpatient department due to suspicion of neural tube defects. A lump was present in the posterior aspect of the sacral region covered with an overlying healthy skin, soft on palpation, fluctuant, and measured about 4 cm x 4 x 1 cm. Spinal magnetic resonance imaging (MRI) showed a focal neural tube defect of 4.9 cm x 4.3 x 1.9 cm at L4, L5, and S1 with tethering of the cord at the L4 level. The patient had a successful repair of the meningocele and later advised on regular follow-up visits. Conclusion: Our case report highlights the challenges associated with occurrence of lipomyelomeningocele, in regions with limited access to prenatal care and folate supplementation. It emphasizes the importance of public health efforts to educate and support pregnant women in remote areas, ultimately reducing the burden of congenital neural tube defects in neonates.