Medical Management of Steroid-Induced Epidural Lipomatosis

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 . . .