Medical Management of Steroid-Induced Epidural Lipomatosis

Abstract

The characteristic features of excess adrenal corticosteroid, including truncal obesity, were first described in 1932 by Cushing.¹ Subsequently, others noted steroid-induced fat deposition in the central body axis, particularly in the episternal area,² mediastinum,^{3 4 5 6 7 8} and epicardium.^{3 4 5 6 7 8 9} In 1975 Lee et al.¹⁰ reported neurologic symptoms due to extradural fat in a renal-transplant recipient who was receiving prednisone. Since then, there have been seven similar cases associated with exogenous steroid administration.^{11 12 13 14 15} All the patients had signs suggesting a myelopathy and confirmatory radiologic findings, and all underwent decompressive laminectomy performed in an attempt to remove the extradural mass. We describe an additional case . . .