Background： Intramedullary lipomas can sometimes be misdiagnosed as syringomyelia. In this report, we describe a case of intramedullary lipoma that presented with symptoms similar to syringomyelia and review the relevant literature.

Case presentation： A 35-year-old woman was admitted to the hospital due to hypoesthesia in her right limb, particularly in her leg. Spinal magnetic resonance imaging revealed a C5-T7 lesion and an L2–L3 lesion with hyperintensity in T1-weighted and T2-weighted image hypointensity in T1 fat suppression-weighted images. The lumbosacral lesion was resected, and the pathological results indicated cholesteatoma, while based on the clinical manifestation and imaging results, the cervicothoracic lesion was considered to be a lipoma and was observed without surgery. The patient's neurological function in the lower limb improved in 1 month after surgery.

Conclusion： Special caution should be exercised when attempting to differentiate between intramedullary lipoma and syringomyelia before surgery.

Intramedullary lipoma mimicking syringomyelia: A case report and literature review