Extradural and intrathoracic lipoma causing spinal cord compression. Successful treatment by surgical excision.

When a nonmalignant growth with rare features closely simulates a relatively common malignant neoplasm, proper therapy may unfortunately be delayed. If a benign tumor compressing the spinal cord is not promptly operated upon, irreversible neurological damage may ensue. This case of extradural and intrathoracic lipoma causing spinal cord compression in a child presented clinical and radiologic features most compatible with a diagnosis of neuroblastoma. Operation, however, revealed that the patient had a benign lipoma which could be excised by a 2-stage operation with resultant cure. To distinguish the erosion of ribs by benign tumors and vascular structures from the destruction of ribs by a malignant neoplasm is difficult; the pitfalls in differential radiologic diagnosis are discussed.