Signal intensity patterns in intraspinal dermoids and epidermoids on MR imaging

Gupta, Sanjay; Gupta, Rakesh K.; Gujral, R. B.; Mittal, Piyush; Kuriyal, M.; Krishnani, Narendra

doi:10.1016/s0009-9260(05)81110-9

Cited by 31 publications

(20 citation statements)

References 13 publications

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“…Approximately half of all dermal sinuses have associated dermoid or epidermoid cysts, usually at the termination of the tract [3]. Due to the fatty component (triglyceride) of these lesions, most of spinal dermoids exhibit low intensity on T1-weighted images and high intensity on T2-weighted images [6]. Our patient presented as isointense on T1-weighted images and hypointense on T2-weighted images, with a homogeneously enhancing mass lesion present from Th12 to S1 with ring-like enhancing cystic lesions on both the rostral and caudal sides.…”

Section: Discussionmentioning

confidence: 99%

Reversible Holocord Edema Associated with Intramedullary Spinal Abscess Secondary to an Infected Dermoid Cyst

Tsurubuchi

Matsumura²,

Nakai³

et al. 2002

Pediatr Neurosurg

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We report a case of a holocord high-intensity lesion extending from L1 up to the medulla oblongata on T2-weighted spinal magnetic resonance imaging (MRI) associated with an intramedullary spinal abscess secondary to an infected dermoid cyst. The intraoperative findings revealed that the high-intensity lesion on the T2-weighted image was edematous tissue. The MRI change in the spinal cord gradually improved in response to the use of postoperative antibiotics. The change was considered to represent reversible inflammatory changes, as there was no neurological deficit found at the cervical level and it resolved after surgery and medical treatment. The pathomechanism is discussed herein.

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Section: Discussionmentioning

confidence: 99%

Reversible Holocord Edema Associated with Intramedullary Spinal Abscess Secondary to an Infected Dermoid Cyst

Tsurubuchi

Matsumura²,

Nakai³

et al. 2002

Pediatr Neurosurg

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“…Moreover, Teksam et al reported EC features on diffusion-weighted MRI, as the apparent diffusion coefficient (ADC) values indicated restricted diffusion within the lesion (15). However, these findings are not always constant on imaging modalities and some variations have been reported in the literature (16). High signal intensity on both T1 and T2-weighted MRI was noted for our presented case.…”

Section: Discussionmentioning

confidence: 53%

Multi-Segmental Intramedullary Epidermoid Cyst Causing Low Back Pain and Urologic Dysfunction

Seddighi

Nikouei

et al. 2017

Int J Cancer Manag

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Introduction: Epidermoid cysts (ECs) are rare, slow growing tumors which usually affect lumbosacral area as an extramedullary lesion and mostly associated with spinal malformations. In this report we describe a very rare case of multi-segmental intramedullary EC. Case Presentation: A 42-year-old male presented with low back pain and paresthesia of left lower limb and also intermittent urinary retention. Urodynamic study showed weak contractions in bladder. MRI demonstrated multi-segmental lobulated intramedullary lesion extending from C7 to L2, which has high intensity on both T1 and T2-weighted images. Laminectomy of T11-L3 for symptomatic parts of the lesion and subtotal resection of the tumor was performed and histopathological investigation confirmed EC. Conclusions: Prompt evaluation of every patient with combination of neurological and urologic disturbances should be carried out. This report suggests that rare intraspinal tumors such as EC may affect multiple locations of the spinal cord, thus appropriate surgical intervention may prevent unwanted sequelae.

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“…On MRI, the tumor is usually isointense or hypointense in T1-weighted images and hyperintense in T2-weighted images and the cyst content has the same signal as the cerebrospinal fluid [17-19]. But these signal characteristics are not always constant and some variations have been reported in the literature [18,20,21]. The MRI results for five patients in our series were consistent with the typical imaging findings reported in the literature while for one patient out of the six there were unusual images (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Surgery and outcomes of six patients with intradural epidermoid cysts in the lumbar spine

Yin

Zhang

et al. 2014

World J Surg Onc

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Study designThis was a retrospective study.ObjectiveThe aim of this study was to analyze the clinical characteristics and discuss the treatment options for epidermoid cysts in the lumbar spine.Summary of background dataEpidermoid cysts are rare benign neoplasms, which account for less than 1% of all intraspinal tumors. Due to their rarity, there are only a few case reports in the literature. Complete excision is the recommended treatment for an epidermoid cyst, but this is difficult to achieve in the spine. In spite of their benign nature, local recurrence is not uncommon for spinal epidermoid cysts after incomplete excision.MethodsSix patients with an epidermoid cyst in the lumbar spine underwent surgical treatment in our center between 2004 and 2011. A total excision using microsurgical techniques and reconstruction was successfully undertaken in all patients. Clinical data and detailed pathologic results were retrospectively analyzed. All cases were followed up for a median time of more than 4 years. The clinical data and surgical efficacy were analyzed to suggest treatment options for epidermoid cysts in the lumbar spine on the basis of a literature review and our own experience.ResultsThe mean age of the patients in this study was 37.7 years and the mean duration of pre-operative symptoms was 29.7 months (2 to 120 months). All patients were disease-free during their follow-up period. Radicular pain nearly disappeared, and patients suffering from neurologic deficits and defecation disorders recovered well.ConclusionsAlthough an epidermoid cyst is a benign tumor, it is apt to recur locally following inadequate removal. Therefore, complete excision with preservation of neural function is an ideal protocol for intraspinal epidermoid cysts. Microsurgical techniques are very useful.

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Signal intensity patterns in intraspinal dermoids and epidermoids on MR imaging

Cited by 31 publications

References 13 publications

Reversible Holocord Edema Associated with Intramedullary Spinal Abscess Secondary to an Infected Dermoid Cyst

Reversible Holocord Edema Associated with Intramedullary Spinal Abscess Secondary to an Infected Dermoid Cyst

Multi-Segmental Intramedullary Epidermoid Cyst Causing Low Back Pain and Urologic Dysfunction

Surgery and outcomes of six patients with intradural epidermoid cysts in the lumbar spine

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