Angiolipomas are extremely rare tumors in the spinal canal with approximately 100 cases reported in the literature. Most commonly, these tumors involve the posterior epidural compartment in the mid-thoracic region. Intradural, intramedullary, intracranial, lumbar region, locally infiltrating, pediatric, and pregnancy-related presentations represent the most unusual and rarest reports. These tumors have not been entirely well characterized, but are histopathologically distinct from subcutaneous lipomas. The MRI imaging characteristics of angiolipomas are variable, but they usually present as hyperintense lesions on T1- and T2-weighted sequences, and show intense, homogeneous contrast enhancement with contrast-enhanced, fat-saturated, T1-weighted images. Complete surgical resection is curative, but not always achievable. These tumors are benign and carry an excellent prognosis; even with subtotal resection, residual tumor is seldom problematic. Second recurrence is a rare exception. We report a case of thoracic, extradural, spinal angiolipoma in a 40-year-old male with slowly progressive symptoms of myelopathy. This extremely rare diagnosis should be considered in the differential for spinal neoplasms.

Key words: angiolipoma, epidural, laminectomy, neoplasm, spinal