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Tethered spinal cord with filum terminale lipoma
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902
( There are questions in the CMK-Mode for this topic )
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 | Images to this case: |  [ MRI ]  [ All ] | |
| | Author/s: | Wolfgang Hirsch (Leipzig) | |
| | Email Address: | Viewable for logged on visitors (Log on) | |
| | Age: | 15 Years | |
| | Gender: | Male | |
| | Region-Organ: | Spinal canal / Myelon | |
| | Most likely etiology: | neoplastic | |
| | History: | 15 year-old boy, for 6 months increasing waddling gait. Urinary incontinence recently began. Suggestion of pes cavus on both sides. | |
| | Pathomorphology or Pathophysiology of this disease : | A tethered cord syndrome develops from a fixation of the mostly thickened filum terminale at the sacrum. In dysraphy (myelomeningocele), there is (almost) always a TC. Very often there are lipomas in or around the filum (inclusion tumors).
The harm usually occurs through the years by slowly ischemic alterations of the conus medullaris, which is particularly harmed through bending motions. Also, the often-called conus low-level is not always to be seen initially. A normal conus level does not therefore necessarily rule out a TC. | |
| | Radiological findings: |
 <- view MRI 1
MRI 1: T1-weighted sag: high signal tumor below the conus medullaris, which is at the level of the 2nd lumbar vertebra. This could be fat or Meth-Hb.
 <- view MRI 2
MRI 2: T2 weighted without fat saturation: high signal tumor, which fills the spinal canal at the level of the 3rd lumbar vertebra. This could be fat or fluid. Within the conus medullaris there is a widened syrinx/hydromyely seen.
 <- view MRI 3
MRI 3: T2-weighted with fat saturation: the signal in the filum tumor-inclusion disappears, and the hydromyely remains. Therefore it is surely a tumor with fatty contents.
 <- view MRI 4
MRI 4: T1-weighted before contrast media: The signal of the tumor has disappeared.
 <- view MRI 5
MRI 5: T1-weighted after contrast media: A contrast media uptake is not seen.
 <- view MRI 6
MRI 6: Subtraction images before and after contrast media: A contrast media uptake is not seen.
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| | Diagnosis confirmation: | Total constellation (Consens) | |
| | Which DD would be also possible with the radiological findings: | Teratoma, in this MRI-constellation no others. | |
| | Course / Prognosis / Frequency / Other : | Surgery to relieve the cauda is necessary. | |
| | Comments of the author about the case: | N/A | |
| | First description / History: | N/A | |
| | Literature: | N/A | |
| | Keywords: | tethered cord, filum, lipoma, inclusion TM, tethered spinal cord, dysraphy, thickened filum terminale, waddling gait, urinary incontinence, myelomeningocele, filum terminale lipoma, filum terminale, conus terminale, conus terminale lipoma, child, childhood, pediatric radiology | |
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Cite this article: |
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902 |
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Read similar articles: |
with corresponding keywords
in the same field: Spinal canal / Myelon
or in the region: Spinal canal / Myelon
or in the tissue/organ:
or with the etiology: neoplastic
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| | Images to this case: | [ MRI ] [ All ] | |
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Tethered spinal cord with filum terminale lipoma
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902
( There are questions in the CMK-Mode for this topic )
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Tethered spinal cord with filum terminale lipoma
Other cases by these authors:
 Wolfgang Hirsch (17)
Tethered spinal cord with filum terminale lipoma |
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Tethered spinal cord with filum terminale lipoma
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902
( There are questions in the CMK-Mode for this topic )
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Which diagnosis have other collegues guessed?
- Astrocytoma
Votes: 2 (7 %)
- Metastasis of a medulloblastoma
Votes: 1 (3 %)
- Tethered-Spinal-Cord because of inclusion tumor (Lipoma) in the filum terminale
Votes: 23 (82 %)
- Hemorrhagic metastasis
Votes: 1 (3 %)
- Metastasis of a neuroblastoma
Votes: 1 (3 %)
Total answers: 28
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Tethered spinal cord with filum terminale lipoma
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902
( There are questions in the CMK-Mode for this topic )
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Tethered spinal cord with filum terminale lipoma
Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030206170902
( There are questions in the CMK-Mode for this topic )
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