A rare case of lumbar intraspinal osteolipoma presenting with a sciatic pain.

Background: Osteolipoma constitutes <1% of all lipomas. They are only rarely located in the spine. Here, we report an extremely rare lumbar intraspinal osteolipoma, along with a review of its clinical and radiological features.

Case description: A 57-year-old male presented with a 1-year history of progressively worsening of his sciatica. The magnetic resonance imaging (MRI) revealed a right-sided extradural lesion compressing the cauda equina at the L3/L4 level. The lesion was hyperintense with a hypointense rim on both T1- and T2-weighted images, while the computed tomography (CT) showed that it was hyperdense (i.e., osseous). Following operative resection, the patient's symptoms resolved. Pathologically, it proved to be a benign osteolipoma.

Conclusion: MRI and CT studies documented a L3/4 extradural, osseous lesion causing cauda equina compression. Following surgical removal, the patient's symptoms fully resolved.