Spinal angiolipoma mimicking extradural lipomatosis.

Spinal angiolipoma is a rare, benign tumour. More than 90% of cases arise extradurally. The authors report an extradural spinal angiolipoma in a 54-year-old man. Conventional T1-weighted and T2-weighted magnetic resonance imaging (MRI) demonstrated an excessive amount of extradural adipose tissue posteriorly, extending from the level of the third to the ninth thoracic vertebra. The signal intensity within the spinal cord was normal. These findings were initially misinterpreted as being of little clinical significance. When the patient's condition deteriorated, myelography was performed, and extradural compression of the thecal sac was demonstrated. At surgery spinal angiolipoma was confirmed. The ease with which the MRI features of this lesion can be overlooked, as well as imaging strategies to avoid this pitfall, are discussed.

Percutaneous gastrostomy without gastropexy.

OBJECTIVES: To describe in detail the technique for percutaneous gastrostomy without gastropexy, to determine the overall success rate for this technique in providing access to the gastrointestinal tract for feeding and to determine if routine gastropexy is necessary. PATIENTS AND METHODS: The authors reviewed all cases of percutaneous gastrostomy performed over a 14-month period. In total, 24 patients (12 males and 12 females) underwent insertion of gastrostomy tubes in the radiology department during this period. Eighteen of the patients had ear, nose and throat tumours and the other 6 had feeding difficulties as a result of neurologic disorders. All gastrostomy tubes were inserted under fluoroscopic guidance without sedation or administration of glucagon. Gastric fixation was not employed. RESULTS: All of the procedures were successful. No major complications occurred. One minor episode of chemical peritonitis did not require treatment. CONCLUSIONS: Percutaneous gastrostomy, performed in the radiology department, is safe and effective. On the basis of these findings and a literature review, the authors suggest that routine gastric fixation is not required. However, gastropexy may be appropriate in some circumstances, and its role in these situations has still to be confirmed.