Lipomyelomeningocele

Etiology: Premature dysjunction of cutaneous ectoderm allows mesenchyme to be induced to become fat which interferes with neurulation
Imaging MRI: Lipomatous mass and neural elements extending from the low-lying cord through a defect in the bone and contiguous with subcutaneous fat
DDX:
Complications:
Treatment:
Clinical: Occult skin covered spinal dysraphism or closed spinal dysraphism

Radiology Cases of Lipomyelomeningocele

MRI of lipomyelomeningocele — Sagittal T1 (left), T2 (middle) and T1 with contrast (right) MRI of the lumbar spine show a low-lying conus medullaris at the level of S2, which ends in a lipomatous mass that via a defect in the bone is contiguous with the subcutaneous fat posteriorly.

MR of lipomyelomeningocele — Sagittal T1 MRI without contrast of the spine (above) shows the conus medullaris to be low in position at L5 and to be contiguous with a lipomatous mass in the posterior spinal canal with neural elements extending from the low-lying cord through a defect in the bone posteriorly and being contiguous with subcutaneous fat. Axial T1 MRI at the level of the conus (below left) shows fat adherent to the conus posteriorly and the conus / neural tissue extending into the subcutaneous fat. Axial T2 MRI at the level of the conus (below right) also shows that there is some cerebrospinal fluid extending into the subcutaneous fat as well.

Clinical Cases of Lipomyelomeningocele

Clinical image of lipomyelomeningocele — Clinical image of the back shows a skin covered soft tissue mass just to the left of the midline of the spine.