Four cases of spinal epidural angiolipoma

Highlights • Spinal angiolipomas are rare benign tumours usually found within the posterior spinal epidural space at the mid-thoracic level. • They are composed of varying proportions of mature fatty tissue and abnormal vascular elements with good radiological-pathological correlation on MRI. Tumours with minimal vascular elements may thus be mistaken for normal epidural fat. • Although traditionally divided into non-infiltrating and infiltrating subtypes, infiltrating spinal angiolipomas with bony extension are probably more appropriately classified as aggressive vertebral haemangiomas. • Treatment of symptomatic non-infiltrating spinal angiolipomas is usually with surgical resection, with most patients reporting symptom improvement.