Intracranial dermoid cyst is a rare entity accounting for 0.1–0.7% of all intracranial tumors. The most common location is in the posterior fossa, at or near the midline. We present 2 pediatric cases with dermal sinus. The first case presented with clinical signs of increased intracranial pressure and cerebellar symptoms. CT scan showed a large and regular midline posterior fossa cyst without contrast enhancement. The second case was revealed by recurrent meningitis. CT scan showed a midline vermis low-density mass with capsular contrast enhancement. Dermal sinus was found in 2 cases. Complete surgical removal was performed followed, in a second operation, by ventriculoperitoneal shunt in 2 cases. There was no postoperative complication in our patients. The aim of this study is to discuss the clinical aspects of dermoid cyst, especially in cases with dermal sinus, and to review the therapeutic strategies in case of associated hydrocephalus.
We describe a rare case of the spinal cord compression by a primary Ewing sarcoma of the thoracolumbar spine. A 16-year-old boy was admitted with back pain for 2 month and inability to walk for 15 days. At the presentation, he had paraparesis and bilateral hypoesthesia below the T12 level, without sphincter dysfunction. Thoracolumbar spine magnetic resonance imaging showed an involved vertebral body mass of the L1 extending in the epidural space with an extension into the prevertebral area. The mass was totally removed by the anterolateral approach. Histopathological examination revealed Ewing sarcoma. Although his infrequency, such a primary Ewing sarcoma of the vertebral column should be suspected for lesion causing a spinal cord compression particularly in the children and adolescent that the treatment protocol included a three main modalities: surgery, radiotherapy and chemotherapy.
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