Spinal epidural lipomatosis is the excessive deposition of unencapsulated fat in the epidural space. This is a rare disorder often associated with high levels of endogenous steroids or the administration of exogenous steroids. A precocious diagnosis is important because it influences the clinical evolution and the therapeutics option. The computed tomography (CT) and magnetic resonance imaging (MRI) are very important to the diagnosis. Authors report a case of a mediastinal and epidural lipomatosis in a man receiving corticoid therapy, with symptoms consistent with acute respiratory failure and progressive paraparesis.

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