Idiopathic spinal epidural lipomatosis without obesity: a case with relapsing and remitting course

Study design: Case report of a rare form of idiopathic spinal epidural lipomatosis (SEL) manifesting with relapsing and remitting course. Objective: To describe this very rare clinical and pathological condition and the results of surgical intervention. Setting: A department of neurosurgery in Morocco. Methods: A 24-year-old man presented with a 2-year history of mid-thoracic back pain and progressive neurogenic claudication with two episodes of remitting and relapsing course. Spinal magnetic resonance imaging revealed a fatty epidural mass extending from T4 to T9. Posterior decompression was performed, and he was followed for 3 years after the operation. Results: Pathological examination of the surgical specimen revealed nodules of mature fat cells without neoplasm. The patient's symptoms completely resolved after surgical decompression. Conclusion: Fluctuating clinical course has not been reported previously in SEL. Such pathology should be considered in the differential diagnosis of demyelinating diseases.