Intraosseous lipoma of the third lumbar spine: a case report

INTRODUCTION: Intraosseous lipoma is a benign bone tumor, and the tumor occurs more frequently in the lower extremities. We present a very rare case of intraosseous lipoma occurring in the lumbar vertebral arch and spinous process. CASE PRESENTATION: A 54-year-old Japanese man presented with a three-month history of lumbar pain. Magnetic resonance imaging of the L3 vertebral arch and spinous process revealed high intensity on T1- and T2-weighted imaging, and it was suppressed on fat-suppression imaging and no enhancement showed on gadolinium contrast-enhanced imaging. Computed tomography imaging revealed an osteolytic change accompanied by marginal osteosclerosis in his third lumbar vertebral arch and spinous process, as well as a thinned and bulging bone cortex. An analgesic had been administered prior to his visit, but low back pain had persisted, so we performed curettage and filled the defect with hydroxyapatite bone. His low back pain was improved immediately after surgery, and no recurrence of tumor has been observed on computed tomography imaging as of three years postoperatively. CONCLUSIONS: Symptomatic intraosseous lipoma of spine is very rare, but the patient may be surgically well-treated by curettage and reconstruction of the benign tumor.