Background: Spinal lipomas sometimes involve various ectopic tissues originating from the ectoderm, mesoderm, and endoderm in the process of morphological development.
Observations: A 29-year-old male patient with myolipoma of the conus medullaris at the S2 and S3 levels was described. The unusual finding, involuntary muscle contraction, was presented in an operative video and a literature review. In the present case, sacral myolipoma with involuntary contraction caused tethered cord syndrome in adulthood, and untethering surgery resolved continuous buttock and leg pain.
Lessons: This rare finding is considered a surgical indication for adult patients with myolipoma.
Keywords: MRI = magnetic resonance imaging; lipoma; lipomeningocele; lipomyelomeningocele; neural tube defect; spina bifida; spinal dysraphism.
© 2022 The authors.