Spinal epidural lipomatosis

We present a case of an 87-year-old man with spinal epidural lipomatosis (SEL). The patient had been diagnosed with microscopic polyangiitis and treated with prednisone at a 5mg daily dose. He has a 1-week history of progressive low back pain radiating to the posterior of the right thigh. A spinal magnetic resonance imaging scan revealed SEL in L2-L4. SEL is a rare condition with adipose tissue accumulation in the spinal canal's epidural space, leading to spinal cord or nerve root compression. The greatest risk of SEL is corticosteroid use, and corticosteroid reduction may improve the disease. Physicians should list SEL in the differential diagnosis if a patient on corticosteroid therapy presents with back pain and acute cauda equina symptoms.