Miscellaneous Intramedullary Pathology

Metastases account for approximately 2% of intramedullary tumors. This low prevalence is likely due to the small size of the spinal cord and its poor vascular accessibility to hematoge-nous tumor emboli.12

Other non-neoplastic entities can occur as intramedullary spinal lesions.33,38 Vascular malformations, particularly cavernous angiomas, may occur in the spinal cord. Inclusion tumors and cysts are rarely intramedullary. Lipomas are the most common dysembryogenic lesion and account for approximately 1% of intramedullary masses. These are not true neoplasms but probably arise from inclusion of mesenchymal tissue within the spinal cord itself. They typically enlarge and produce symptoms in early and middle adult years through increased fat disposition in metabolically normal fat cells. Lipomas are often considered juxtamedullary, because they occupy a subpial location.

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