Delayed Onset of an Intradural Epidermoid Tumor in the Lumbar Region Seven Years After Spinal Anesthesia for Childbirth: A Case Report

Abstract

Epidural or spinal anesthesia is commonly administered in births in the US, and the potential risks for epidermoid tumors are not well-characterized. We present the case of a 29-year-old female patient who developed an intradural epidermoid tumor in the lumbar spine, discovered seven years after spinal anesthesia for childbirth. MRI revealed a 4 cm tumor filling the entire spinal canal. Pathology confirmed the mass to be an epidermoid. Complete surgical resection of the intradural lesion was accomplished with full symptomatic relief. This case supports the relationship between delayed development of epidermoid tumors and spinal puncture in adult populations.

Epidural analgesia and tattoos: a modified technique to minimise risks and improve safety

“…The tissue coring phenomenon is described as a possible entrainment of cells when there is any puncture of the skin 11. The vast literature in various medical specialisations, including neurosurgery, paediatrics and anaesthesiology, reports neuraxial epidermoid tumours as a rare complication 12 13. However, recent studies14 15 regard these tumours as an acquired/iatrogenic occurrence in more than 30% of patients with a history of spinal procedures 4 14–19.…”

“…When a neuraxial block, such as an epidural,11 12 39 requires multiple punctures, it is possible that epidermal cells containing hazardous inks25 27 28 40 are dispersed from the upper to the deeper layers of skin. (figure 1) Although long-term complications of performing a CNB through a tattoo are low, they are not zero and hence should be discussed with the patient 4 40 41…”