Four cases of spinal epidural angiolipoma

• Spinal angiolipomas are rare benign tumours usually found within the posterior spinal epidural space at the mid-thoracic level.
• They are composed of varying proportions of mature fatty tissue and abnormal vascular elements with good radiological-pathological correlation on MRI. Tumours with minimal vascular elements may thus be mistaken for normal epidural fat.
• Although traditionally divided into non-infiltrating and infiltrating subtypes, infiltrating spinal angiolipomas with bony extension are probably more appropriately classified as aggressive vertebral haemangiomas.
• Treatment of symptomatic non-infiltrating spinal angiolipomas is usually with surgical resection, with most patients reporting symptom improvement.

Spinal angiolipomas are uncommon benign tumours composed of mature fatty tissue and abnormal vascular elements, most commonly found within the posterior spinal epidural space. Most tumours are located within the mid-thoracic spine; in contrast thoracolumbar junction and purely lumbar angiolipomas are rare. We report a case series of four spinal angiolipomas, including a thoracolumbar junction and a purely lumbar tumour.