This is a 30 year old patient with evidence of focal area of T1/T2 hyperintensity in relation to intradural compartment at L1-L2 level inseparable to conus terminalis possibly indicating intradural lipoma. No obvious posterior element dysraphism. No obvious communication to subcutaneous adipose tissue.
Intradural spinal lipoma is the least common form of spinal lipoma representing less than 1% of primary spinal tumours. They are believed to be embryogenetic in origin and are related to lipomyelo(meningo)cele with which they share a common origin in the separation of the neural from the cutaneous ectoderm during neurolation that allows some mesoderm to gain the dorsal surface of the neural tissue. This mesoderm constitutes the lipoma by transforming into fat tissue; it remains incarcerated in the folding neural tissue in which it prevents complete dorsal fusion but, in distinction to myelo(meningo)cele, does not prevent the dorsal fusion of the dura and of the osseous posterior elements of the spine.