Microsurgical treatment of spinal epidermoid and dermoid cysts in the lumbosacral region

Background:Dermoid tumors are slow growing, benign CNS lesions.Case Description:This case study concerns a 29-year-old female with a 6-year history of lower extremity paresthesias attributed to magnetic resonance (MR)/computed tomography (CT) documented intradural dermoid tumor that extended from L1 to S1. On MR, it was hypointense on T1, hyperintense on T2, and did not enhance with gadolinium. CT showed hyperdensity at the L1-L2 levels. The craniocervical MR imaging showed small hyperintense foci in the cisternal space favoring “fat dissemination.” L1-S2 laminectomy revealed an intradural lesion characterized by “a solid and firm component compatible with fat tissue adherent to the conus medullaris and a solid-soft component within the cauda equina;” there were also “multiple fragments of white-creamy soft tissue with hair.” Following tumor resection, the brain CT scan demonstrated fat dissemination within the intraventricular and cisternal space. Histopathologic examination confirmed the diagnosis of a dermoid tumor.Conclusion:Dermoid tumors should be considered among the differential diagnosis of intradural lesions in young patients even without any other congenital abnormality.

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“…[56] They constitute only 0.7–1.1% of all spinal tumors. [3] Here, we present a 29-year-old patient with an L1-S2 intradural dermoid tumor.…”

Section: Introductionmentioning

confidence: 99%

Long standing lumbosacral dermoid tumor and intracranial fat droplet dissemination: A case report

2016

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“…It is often related to spinal dysraphism or occasionally occurs as a result of repeated lumbar punctures. The appearance of intradural intramedullar epidermoid tumors is extremely rare (1).…”

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confidence: 99%

“…In congenital epidermoid tumors, a benign tumor forms as the result of inclusion of ectodermal tissue during normal tube formation at between 3-5 weeks of embryological development (3). The developmental form often develops associated with the movement of skin tissue during a lumbar puncture (1).…”

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confidence: 99%

“…Cerebrospinal fluid (CSF) is at the same intensity. However, dermoid tumors are generally seen as hyperintense on T1, due to the presence of fatty secretions from sebaceous glands and cholesterol, and are hypointense on T2-weighted images (1). Epidermoid tumors do not show contrast.…”

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confidence: 99%

“…Therefore, delayed diagnosis increases the risk of complications. Surgical treatment is curative (1). To the best of our knowledge, there are a limited number of pediatric cases of epidermoid tumors in the literature.…”

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confidence: 99%

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Spinal inclusion cysts

Thompson

2013

Childs Nerv Syst

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Spinal inclusion cysts are aetiologically diverse lesions, though in paediatric practice, most occur in association with a dysraphic anomaly. There are no consistent clinical or radiological features that will reliably distinguish between dermoid and epidermoid, and both may result in symptoms from mass effect or infection. The recurrence rate is low if complete macroscopic resection can be achieved.

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Microsurgical treatment of spinal epidermoid and dermoid cysts in the lumbosacral region

Cited by 34 publications

References 32 publications

Long standing lumbosacral dermoid tumor and intracranial fat droplet dissemination: A case report

Long standing lumbosacral dermoid tumor and intracranial fat droplet dissemination: A case report

Epidermoid Tumor with Tethered Cord

Spinal inclusion cysts

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