Spinal Lipoma, Cervical

42-year-old female with history of long-standing myelopathy and diagnosis of intradural lipoma of the cervical spine. There is a well-circumscribed, T1 hyperintense mass extending from the inferior most aspect of the posterior cranial fossa through the foramen magnum, and effacing the surgically enlarged upper and mid cervical spinal region. The lesion is also T2 hyperintense and suppresses on the fat suppressed images. There are T1 hypointense components of the lesion which reflect severely gliotic and myelomalacic neural elements. The sagittal fat-supressed image demonstrates profound myelomalacia of the lower cervical spinal cord extending to the upper thoracic spine. The majority of intradural lipomas are extramedullary in location and adjacent to the cord substance. Lipomas may occasionally involve the cord substance and rarely be centered within the substance of the cord itself. Associated vertebral and dermal abnormalities are not typical. Treatment choices include surgical resection and/or decompression of the affected levels.