Spontaneous shrinkage of lumbosacral lipoma in conjunction with a general decrease in body fat: case report

OBJECTIVE AND IMPORTANCE: We describe a rare case of a lumbosacral lipoma that shrank spontaneously in parallel to a general loss of body fat. Although early prophylactic surgery is generally recommended for lumbosacral lipomas, the observation made in this case may provide an important implication regarding the conservative management of this disorder. CLINICAL PRESENTATION: A 9-year-old male patient with a subcutaneous lipoma at the sacral level was found to have a lumbosacral lipoma in the spinal canal and tethered spinal cord, as revealed by magnetic resonance imaging. The patient showed no neurological or urological deficits, except for a mild pes cavus deformity. INTERVENTION: Follow-up magnetic resonance imaging performed 4 years later revealed a significant decrease in the size of the lumbosacral lipoma. The patient became very thin and showed no neurological deterioration during the follow-up period. The shrinkage of the lipoma was considered to be in association with the general loss of body fat. CONCLUSION: The control of body weight may be an important factor in the conservative management of patients with lumbosacral spinal lipomas.