lipomeningocele
description
this is a lesion of the lumbosacral spine that occurs in conjunction with spina bifida. the lipoma originates from the spinal cord or cauda equina, and is confined to the lumbosacral region, most commonly within the filum terminale. at this site the cord is noted to be contiguous with a subcutaneous lipoma in association with spina bifida occulta. the main concern is of cord tethering in infancy, so early diagnosis of the lesion will facilitate prompt surgical treatment.
diagnosis
a distinct echogenic mass is seen immediately adjacent to a dysraphic fetal spine in the lumbosacral region. the maternal serum alphafetoprotein screen will be negative due to the closed nature of the defect, and the normal cranial signs of spina bifida are likely to be absent. if the diagnosis can be made prenatally parents can be assured of an excellent prognosis with no development of hydrocephalus and minimal if any neurological deficit.
differential diagnosis
the differential diagnosis will include open spina bifida and other isolated intraspinal cysts.
sonographic features
echogenic intraspinal mass.
associated spina bifida occulta.
associated syndromes
- goldberg
references
seeds jw, powers sk early prenatal diagnosis of familial lipomyelomeningocele obstet gynecol 72: 469-471