Uncommon Extradural Spinal Fibrolipoma in a Child: A Case Report

Abstract

Pediatric spinal tumors include a variety of developmental lesions and uncommon neoplasms that differ significantly from those seen in adults. These conditions are underreported in the sub-Saharan medical literature. We present the case of a 10-year-old girl brought by her family to the University Teaching Hospital of Kinshasa in the Democratic Republic of Congo with progressive lower limb functional impairment. On admission, the patient was alert, with normal vital signs, pink palpebral conjunctiva, anicteric sclerae, unremarkable cardiopulmonary and spinal examinations, and no spinal deformities. However, palpation revealed tenderness along the dorsal spinous processes from T1 to T10, and a sensory level corresponding to the T4 dermatome was noted. The patient was paraplegic and wheelchair-bound, with a lower limb American Spinal Injury Association (ASIA) motor score of 20/50. A CT scan of the thoracolumbar spine revealed no disc or vertebral abnormalities. An MRI demonstrated an extensive extradural, intracanal mass from T1 to T10 causing spinal cord compression. The mass exhibited signal characteristics suggestive of a fat-containing lesion. A posterior surgical approach was performed for tumor excision 20 days after admission. Histopathological analysis confirmed an inflammatory fibrolipomatous tumor. Postoperatively, the patient showed significant neurological improvement after three months of physiotherapy. This report highlights the diagnostic and therapeutic challenges associated with rare spinal lesions in children.