{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:21Z","timestamp":1784557041173,"version":"3.55.0"},"reference-count":0,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10,19]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Excess cortisol is associated with hypertrophy and redistribution of adipose tissue leading to central obesity which is classically seen in Cushing\u2019s syndrome. Abnormal accumulation of fatty tissue in the spinal canal is most commonly associated with chronic steroid therapy and rarely reported with endogenous Cushing\u2019s syndrome. Herein, we describe a case of spinal epidural lipomatosis (SEL) associated with Cushing\u2019s disease. A 17-year-old man was referred with lower limb weakness, weight gain, multiple stretch marks, back pain and loss of height. He had clinical and biochemical features of Cushing\u2019s syndrome. MRI and Inferior Petrosal Sinus Sampling (IPSS) confirmed a pituitary adenoma as the source. On day 1 post trans-sphenoidal adenectomy he developed spastic paraparesis with a sensory deficit to the level of T5. MRI spine showed increased fat deposition in the spinal canal from T2 to T9 consistent with a diagnosis of SEL. He was managed conservatively and made a good recovery following restoration of eucortisolism and a period of rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>SEL is a serious complication of glucocorticoid excess and should be considered in any patient presenting with new lower limb neurological symptoms associated with hypercortisolism.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>It is important to distinguish symptomatic SEL from cortisol-induced proximal myopathy by good history and clinical examination.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>MRI of the spine is the gold standard investigation for making a diagnosis of SEL.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Restoration of eucortisolism can lead to resolution of fat accumulation and good neurological outcome.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-20-0111","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T10:12:43Z","timestamp":1603188763000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":9,"title":["Spinal epidural lipomatosis: a rare association of Cushing\u2019s disease"],"prefix":"10.1530","volume":"2020","author":[{"given":"Sajjad","family":"Ahmad","sequence":"first","affiliation":[{"name":"1GIM\/Diabetes & Endocrinology, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Best","sequence":"additional","affiliation":[{"name":"2Glan Clwyd Hospital, Bodelwyddan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lansdown","sequence":"additional","affiliation":[{"name":"1GIM\/Diabetes & Endocrinology, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hayhurst","sequence":"additional","affiliation":[{"name":"3Neurosurgery, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Smeeton","sequence":"additional","affiliation":[{"name":"4GIM\/Diabetes & Endocrinology, Neville Hall Hospital, Abergavenny, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Davies","sequence":"additional","affiliation":[{"name":"1GIM\/Diabetes & Endocrinology, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aled","family":"Rees","sequence":"additional","affiliation":[{"name":"1GIM\/Diabetes & Endocrinology, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2020\/1\/EDM20-0111.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2020\/1\/EDM20-0111.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:47:26Z","timestamp":1784555246000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1530\/edm-20-0111","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,19]]}}}