The longest documented recurrence of a Nondysraphic intramedullary spinal cord lipoma: A case report and review of literature

Introduction: Intramedullary lipomas are rare benign spinal cord tumors and even rarer are nondysraphic intramedullary spinal cord lipomas, accounting for less than 1% of all intraspinal tumors. Recurrence after surgical resection is documented, but long-term natural history data remain limited.
Case Presentation: A 54-year-old male presented with progressive bilateral lower limb weakness and posterior column syndrome. He had undergone subtotal resection of a thoracic intramedullary lipoma 30 years previously at age 24 and remained asymptomatic for 28 years. MRI demonstrated a lipomatous lesion extending from D1 to D2. He underwent complete macroscopic resection. Histopathology confirmed benign lipoma. The patient showed excellent functional recovery at six-month follow-up.
Conclusion: This represents the longest documented recurrence interval for nondysraphic intramedullary lipomas. Complete resection can be safely achieved in recurrent cases using modern microsurgical techniques. Lifelong surveillance is mandatory regardless of asymptomatic duration.