1
|
McCullagh K, Zamora C, Castillo M. Troublemaking Lesions: Spinal Tumor Mimics. Neuroimaging Clin N Am 2023; 33:423-441. [PMID: 37356860 DOI: 10.1016/j.nic.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
There are various mass-like lesions that can mimic true neoplasms in the spine, including inflammatory, infectious, vascular, congenital, and degenerative etiologies. While some lesions have distinctive imaging features that suggest a correct diagnosis, others have overlapping characteristics that do not allow their differentiation based solely on their imaging findings. For entities with nonspecific imaging features, knowledge of the clinical and laboratory information is critical to provide an accurate diagnosis.
Collapse
Affiliation(s)
- Kassie McCullagh
- Division of Neuroradiology, Department of Radiology, The University of North Carolina, CB 7510 2000 Old Clinic, 101 Manning Drive, Chapel Hill, NC 27599, USA.
| | - Carlos Zamora
- Division of Neuroradiology, Department of Radiology, The University of North Carolina, CB 7510 2000 Old Clinic, 101 Manning Drive, Chapel Hill, NC 27599, USA
| | - Mauricio Castillo
- Division of Neuroradiology, Department of Radiology, The University of North Carolina, CB 7510 2000 Old Clinic, 101 Manning Drive, Chapel Hill, NC 27599, USA
| |
Collapse
|
2
|
Devathasan D, Murakami M, Miller MA, Thomovsky SA, Lewis MJ. Case Report: Recurrence of an Extradural Spinal Epidermoid Cyst Following Surgical Excision in a Dog. Front Vet Sci 2022; 9:871023. [PMID: 35498737 PMCID: PMC9051319 DOI: 10.3389/fvets.2022.871023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Congenital epidermoid cysts are slow-growing, mass lesions caused by the abnormal inclusion of neuroectodermal tissue within the developing central nervous system. Subtotal excision of epidermoid cysts increases the risk of early recurrence of clinical signs. A 4-year-old female spayed boxer was presented with a 4-month history of ambulatory paraparesis and proprioceptive ataxia. Neurological examination localized a T3-L3 myelopathy. MRI revealed a T1 iso- to hypointense, T2 and FLAIR hyperintense, rim-enhancing mass at the level of the T9-T10 vertebrae resulting in extradural compression of the spinal cord. This was histopathologically confirmed as an extradural epidermoid cyst following subtotal excision. MRI performed 2 months post-operatively revealed a significant decrease of the lesion volume. The dog was neurologically normal following the surgery however re-presented 28 months later with recurrence of clinical signs. A 28-month post-operative MRI revealed substantial enlargement of the epidermoid cyst. The dog was subsequently taken for repeat decompressive surgery. At 6 months from the repeat surgery, the dog was neurologically static with mild proprioceptive deficits. The case report highlights the clinical and MRI features of a recurrent extradural spinal epidermoid cyst treated by subtotal excision.
Collapse
Affiliation(s)
- Dillon Devathasan
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, United States
- *Correspondence: Dillon Devathasan
| | - Masahiro Murakami
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Margaret A. Miller
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Stephanie A. Thomovsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Melissa J. Lewis
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| |
Collapse
|
3
|
Aggarwal V, Narang A, Jain R, Maheshwari C, Kavita D. Surgical Nuances of Intramedullary White Epidermoid Cyst in the Conus Medullaris: A Rare Entity. Asian J Neurosurg 2021; 16:614-617. [PMID: 34660381 PMCID: PMC8477828 DOI: 10.4103/ajns.ajns_321_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
Spinal epidermoid cysts (ECs) are benign slow-growing spinal tumors. The account for <1% of spinal tumors and are usually found intradural extramedullary. This report is regarding two rare cases of intramedullary white ECs present at the conus medullaris. In the first case, a 32-year-old male presented with a complaint of lower backache for 5 years, which progressively increased in intensity, radiating to the left leg. The patient had left lower limb weakness in the form of difficulty in walking. On examination, power of left knee and ankle was 4/5. Left extensor hallucis longus power was 3/5. Left Babinski sign was extensor. In the second case, a 42-year-old male, presented with a complaint of numbness over the left foot for 5–6 months. On examination, the power of the left ankle was 3/5, left extensor hallucis longus was 3/5. Both patients had EC in conus medullaris, which was hyperintense on T1-weighted magnetic resonance imaging and underwent laminectomy with the evacuation of the cyst with electrocoagulation of cyst epithelial lining. White ECs are extremely rare in the conus medullaris. Electrocoagulation of the cyst wall is like walking on a tight rope. Liberal electrocoagulation can lead to the neurological deficit but decreases the chances of recurrence. On the other hand, conservative electrocoagulation can lead to recurrence but decreases the chance of a new deficit. Recurrence should also lead to suspicion of atypical changes in the cyst wall, which may require adjuvant treatment such as radiotherapy and chemotherapy.
Collapse
Affiliation(s)
- Varun Aggarwal
- Neurosurgery, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Amit Narang
- Neurosurgery, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Rahul Jain
- Neurosurgery, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Chandni Maheshwari
- Neurosurgery, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Divya Kavita
- Neurosurgery, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| |
Collapse
|
4
|
Neyaz Z, Prasad SN, Singh V, Phadke RV. Repeated aspiration and sclerotherapy to manage recurrent spinal epidermoid cyst. BMJ Case Rep 2021; 14:14/7/e239730. [PMID: 34253510 DOI: 10.1136/bcr-2020-239730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Spinal epidermoid cysts are rare lesions and epidermoid cyst in intramedullary location is even rarer. Surgical excision is the mainstay of treatment; however, in cases of recurrence, repeat surgery becomes quite difficult. Treatment of recurrent intramedullary epidermoid cyst by surgery alone is a challenge. We managed one such rare case with repeated aspiration and sclerotherapy. Here, we have highlighted hypertonic saline sclerotherapy as a promising tool to treat recurrent spinal epidermoid cysts.
Collapse
Affiliation(s)
- Zafar Neyaz
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Surya Nandan Prasad
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivek Singh
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rajendra Vishnu Phadke
- Interventional Radiology, Apollomedics Super Speciality Hospitals, Lucknow, Uttar Pradesh, India
| |
Collapse
|
5
|
Maurya VP, Singh Y, Srivastava AK, Das KK, Bhaisora KS, Sardhara J, Behari S. Spinal Dermoid and Epidermoid Cyst: An Institutional Experience and Clinical Insight into the Neural Tube Closure Models. J Neurosci Rural Pract 2021; 12:495-503. [PMID: 34295103 PMCID: PMC8289537 DOI: 10.1055/s-0041-1724229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives
The spinal dermoid and epidermoid cysts (SDECs) are rare entities comprising less than 1% of pediatric intraspinal tumors. The present study aims to extrapolate the clinicoradiological data, in order to identify the most plausible neural tube closure model in human and provide a retrospective representation from our clinical experience.
Materials and Methods
We collected the details of all histologically proven, newly diagnosed primary SDECs who underwent excision over the past 20 years. Secondary or recurrent lesions and other spinal cord tumors were excluded. Surgical and follow-up details of these patients as well as those with associated spinal dysraphism were reviewed. Clinical and radiological follow-up revealed the recurrence in these inborn spinal cord disorders.
Results
A total of 73 patients were included retrospectively, having a mean age of 22.4 ± 13.3 years, and 41 (56.2%) cases fell in the first two decades of life. Twenty-four (32.9%) dermoid and 49 (67.1%) epidermoid cysts comprised the study population and 20 of them had associated spinal dysraphism. The distribution of SDECs was the most common in lumbosacral region (
n
= 30) which was 10 times more common than in the sacral region (
n
= 3). Bladder dysfunction 50 (68.5%) and pain 48 (65.7%) were the most common presenting complaints. During follow-up visits, 40/48 (83.3%) cases showed sensory improvement while 11/16 (68.7%) regained normal bowel function. There was no surgical mortality with recurrence seen in eight till the last follow-up.
Conclusions
The protracted clinical course of the spinal inclusion cysts mandates a long-term follow-up. The results of our study support the multisite closure model and attempt to provide a retrospective reflection of neural tube closure model in humans by using SDECs as the surrogate marker of neural tube closure defect.
Collapse
Affiliation(s)
- Ved P Maurya
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Yashveer Singh
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun K Srivastava
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kuntal K Das
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh S Bhaisora
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jayesh Sardhara
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Behari
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
6
|
Nishimura Y, Hara M, Awaya T, Ando R, Eguchi K, Nagashima Y, Wakabayashi T, Ginsberg HJ. Possible Double Crush Syndrome Caused by Iatrogenic Acquired Lumbosacral Epidermoid Tumor and Concomitant Sacral Tarlov Cyst. NMC Case Rep J 2020; 7:195-199. [PMID: 33062568 PMCID: PMC7538451 DOI: 10.2176/nmccrj.cr.2019-0236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 03/04/2020] [Indexed: 11/24/2022] Open
Abstract
We describe a rare case of 42-year-old female who had possible double crush syndrome caused by iatrogenic spinal epidermoid tumor (ET) associated with lumbar puncture as well as concomitant sacral Tarlov cyst in close proximity. She presented with progressive left-sided perianal pain. She had a history of a Caesarean section with lumbar spinal anesthesia. Magnetic resonance imaging (MRI) demonstrated a relatively small intradural extramedullary solid lesion at L5/S1 level and cystic lesion at S2 level. We considered there were two different lesions, such as a tumor and Tarlov cyst; however, we could not rule out the possibility of a single lesion with two different components. Furthermore, there was a distinct compression at more than one locations along the course of the left S2 nerve root and we suspected possible double crush syndrome. We conducted tumor removal and the lesion turned out to be two different pathologies, such as an ET and Tarlov cyst. Both lesions were intraopertively pinching the left S2 nerve root at different sites as expected. The tumor was successfully removed and the cyst wall was imbricated and sutured. We need to take the possibility of ET into consideration if the patient underwent invasive spinal procedure previously. We also have to pay attention to the possibility of double crush syndrome if the nerve root possibly holding the responsibility for symptoms is compressed at two or more sites. This is the first report of possible double crush syndrome caused by acquired spinal tumor and congenital Tarlov cyst.
Collapse
Affiliation(s)
- Yusuke Nishimura
- Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
| | - Masahito Hara
- Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
| | - Takayuki Awaya
- Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
| | - Ryo Ando
- Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
| | - Kaoru Eguchi
- Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
| | | | | | - Howard J Ginsberg
- Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada
| |
Collapse
|
7
|
Sîrbu OM, Chirteş AV, Mitricã M, Sîrbu CA. Spinal Intramedullary Epidermoid Cyst: Case Report and Updated Literature Review. World Neurosurg 2020; 139:39-50. [DOI: 10.1016/j.wneu.2020.03.207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 11/17/2022]
|
8
|
Rahimizadeh A, Sharifi G. Spinal intramedullary epidermoid cysts: Three case presentations and literature review. Surg Neurol Int 2020; 11:17. [PMID: 32123605 PMCID: PMC7049888 DOI: 10.25259/sni_540_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/14/2019] [Indexed: 12/03/2022] Open
Abstract
Background: True intramedullary epidermoid cysts (IECs) not associated with congenital anomalies or previous spinal procedures are extremely rare. In a review of the literature since 1992, only 29 such cases have been reported. Here, we add three new cases in this category. Case Description: Three adults presented with spastic paraparesis attributed to thoracic IECs. Gross total microsurgical removal was achieved in two cases, while one case was a partial resection due to capsular adherence to the cord. In all three cases, patients sustained complete recoveries of neurological function and remained symptom free for an average of 5 years follow-up. Conclusion: IECs are rare lesions; here, the three located in the thoracic spine, contributed to slow, progressive spastic paraparesis with/without incontinence, and resolved following total (2 patients) and partial (1 patient) resection.
Collapse
Affiliation(s)
- Abolfazl Rahimizadeh
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Guive Sharifi
- Department of Neurosurgery, Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Rkhami M, Gader G, Loukil B, Badri M, Zammel I. Iatrogenic Epidermoid Cyst of the Cauda Equina: A Late Complication of Lumbar Disc Herniation Surgery. World Neurosurg 2020; 133:271-274. [DOI: 10.1016/j.wneu.2019.10.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 10/11/2019] [Accepted: 10/13/2019] [Indexed: 11/24/2022]
|
10
|
Turgut VU, Ekşi MŞ, Özak A, Özcan-Ekşi EE. Cervical intradural extramedullary epidermoid cyst at the background of congenital scoliosis with a semi-segmented C6 hemivertebra. Childs Nerv Syst 2019; 35:1411-1413. [PMID: 30953159 DOI: 10.1007/s00381-019-04144-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/29/2019] [Indexed: 11/24/2022]
Abstract
In the present case study, we present a female adolescent patient harboring a rare clinical presentation of spinal intradural extramedullary epidermoid cyst concomitant with congenital scoliosis. A 17-year-old female patient was admitted to the clinic with long-lasting neck pain. She was neurologically intact yet had cervicothoracic scoliosis. Cervical MRI and CT depicted a right C6 hemivertebra, fused to the lower endplate of the C5 vertebra. At the same vertebra level, she had an intradural extramedullary mass lesion anterior to the spinal cord. We planned to excise the mass lesion first. We used neuromonitoring during the surgery and made the surgery via posterior approach. We observed a pearl-like mass lesion anterolateral to the spinal cord. We excised the mass lesion with its capsule microsurgically via peace-meal route. She was neurologically stable following the surgery. Histopathological diagnosis was epidermoid cyst. Most of spinal inclusion cysts occur secondary to spinal dysraphism or iatrogenic inoculation. Isolated spinal inclusion cyst located anterior to the spinal cord concomitant with vertebral anomalies should be kept in mind before making proper surgical planning. Surgery is the modality of choice for spinal inclusion cyst and should be performed under the guidance of neuromonitoring, especially in cases with lesions located at higher spinal levels.
Collapse
Affiliation(s)
- Veli Umut Turgut
- Clinic of Neurosurgery, Antalya Atatürk State Hospital, Antalya, Turkey
| | - Murat Şakir Ekşi
- School of Medicine, Department of Neurosurgery, Acıbadem University, Göztepe Mah, Mesire Sok, Tütüncü Mehmet Efendi Cad, No:3/34, Tepekule Apart., Kadıköy, Istanbul, Turkey.
| | - Ahmet Özak
- Clinic of Neurosurgery, Antalya Atatürk State Hospital, Antalya, Turkey
| | - Emel Ece Özcan-Ekşi
- School of Medicine, Department of Physical Medicine and Rehabilitation, Bahçeşehir University, Istanbul, Turkey
| |
Collapse
|
11
|
Musali SR, Mohammed I, Gollapudi PR, Maley SK. Dorsal Spinal Intradural Intramedullary Epidermoid Cyst: A Rare Case Report and Review of Literature. J Neurosci Rural Pract 2019; 10:352-354. [PMID: 31001035 PMCID: PMC6454963 DOI: 10.4103/jnrp.jnrp_304_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Epidermoid cysts are commonly seen intracranial lesions but their occurrence in the spine is rare. They account for <1% of all the benign tumors of the spine. These are benign epithelial-lined cysts filled with keratin. They are classified into two types: congenital or acquired. Congenital epidermoid cysts are more commonly associated with spinal dysraphic states such as syringomyelia, dermal sinus and spina bifida whereas the acquired cysts are associated with repeated lumbar punctures. Based on the location, they can be extradural, intradural, extramedullary, or intramedullary. Most of the epidermoids are intradural extramedullary. Intramedullary epidermoid cysts are very uncommon. We report a case of a 6-year-old female patient with dorsal epidermoid cyst with neurological deficits. Magnetic resonance imaging of the spine showed a well-defined lesion from D9 to D12 which was hypointense on T1W1 and heterogeneously hyperintense on T2W2. Surgery was performed to excise the lesion and to decompress the spinal cord. Histopathological examination of the excised lesion confirmed it as an epidermoid cyst.
Collapse
Affiliation(s)
- Siddartha Reddy Musali
- Department of Neurosurgery, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Imran Mohammed
- Department of Neurosurgery, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Prakash Rao Gollapudi
- Department of Neurosurgery, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Sai Kumar Maley
- Department of Pathology, Osmania Medical College, Hyderabad, Telangana, India
| |
Collapse
|
12
|
Singh TD, Swanson A, Burrows AM, Clarke M, Shah S, Ali F, Coon EA. Teaching NeuroImages: Not a typical spinal mass. Neurology 2018; 91:e790-e791. [PMID: 30126887 DOI: 10.1212/wnl.0000000000006031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tarun D Singh
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Amy Swanson
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Anthony M Burrows
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Michelle Clarke
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Sejal Shah
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Farwa Ali
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN
| | - Elizabeth A Coon
- From the Departments of Neurology (T.D.S., F.A., E.A.C.), Pathology (A.S., S.S.), and Neurosurgery (A.M.B., M.C.), Mayo Clinic, Rochester, MN.
| |
Collapse
|
13
|
Lin YP, Li YJ, Chen BL, Guo YH. Lumbar laminotomy and replantation for the treatment of adult spinal epidermoid cyst: A case report. Medicine (Baltimore) 2018; 97:e9334. [PMID: 29505514 PMCID: PMC5943114 DOI: 10.1097/md.0000000000009334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Adult spinal epidermoid cyst (SEC) is a rare tumor. Lumbar laminectomy and tumor removal was a routine surgical procedure for adult spinal epidermoid cyst according to the literature, but postoperative lumbar instability and intractable low back pain may occur. In this study, we presented a brief report of an adult lumbar epidermoid cyst and introduced another surgical approach. PATIENT CONCERNS This 28-year-old woman has been complaining of the severe right buttock pain and right thigh radiating pain for half a year. She had been diagnosed as sacroiliitis, spinal arthritis, and lumbar disc herniation at 3 different hospitals before coming to our hospital. And she received a variety of conservative treatments, including non-steroidal anti-inflammatory drugs, aspirin, acetaminophen, glucocorticoids, acupuncture, physical therapy, and so on. However, her pain did not diminish at all. Finally, we find a space-occupying lesion in her lumbar magnetic resonance images (MRI). The lesion was slightly low, equal, and uneven equal-low signals on T1WI. T2WI showed slightly higher, equal, and uneven equal-high signals. And a thin-rim enhancement was observed on Gd-DTPA-enhanced MRI. DIAGNOSES Adult spinal epidermoid cyst. INTERVENTIONS The patient underwent a surgery of lumbar laminectomy, tumor excision, and spinous process-vertebral plate in situ replantation. OUTCOMES Postoperative pathology prompted that the tumor was cystoid. The patient's symptoms were completely removed 1 week after surgery. Three-month postoperative MRI confirmed that the spinal epidermoid cyst had been completely removed and three-dimensional CT prompted lumbar lamina in situ. Bony fusion occurred at 6 months after the surgery. LESSONS Lumbar laminotomy and replantation provides an ideal option to treat adult spinal epidermoid cyst because it can completely remove the cyst and simultaneously reduce the risk of iatrogenic lumbar instability.
Collapse
|
14
|
Multi-Segmental Intramedullary Epidermoid Cyst Causing Low Back Pain and Urologic Dysfunction. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.9310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Li J, Qian M, Huang X, Zhao L, Yang X, Xiao J. Repeated recurrent epidermoid cyst with atypical hyperplasia: A case report and literature review. Medicine (Baltimore) 2017; 96:e8950. [PMID: 29245264 PMCID: PMC5728879 DOI: 10.1097/md.0000000000008950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Epidermoid cysts are slow-growing, benign tumor which account for less than 1% of all intraspinal tumors and epidermoid cyst with Atypical Hyperplasia is very rare. Surgical resection is the standard treatment of the tumor, but recurrence is not uncommon after incomplete resection. Inappropriate treatment can lead to repeated recurrent. Here, we reported a case of repeated recurrent epidermoid cyst with atypical hyperplasia treated with radiotherapy after surgery. PRESENTING CONCERNS A 40-year-old female presenting with intraspinal epidermoid cyst showed incomplete paraplegia in lower limbs. DIAGNOSIS Back pain reappeared 19 months later after surgical treatment. The patient suffered marked weakness in both limbs, along with obvious muscle atrophy and sensation deficiency of warmth and pain in left lower limb. MRI demonstrated a cystic mass with solid content and peripheral strengthen in enhanced scan. INTERVENTIONS Extended excision with intraoperative local chemotherapy and postoperative radiotherapy was performed and a dramatic reversal of symptoms was gained 4 weeks after surgery, with a total dose of 46 Gy. Postoperative pathological examination revealed epidermoid cyst with mild to moderate atypical hyperplasia. OUTCOMES No acute side effects of the treatment were reported. Back pain obviously alleviated within 48 hours after surgery, while weakness and numbness of the lower limbs gradually improved and nearly disappeared in the 3-monthly follow-up visit. Until now, no recurrence is found during the 5-years follow-up. LESSONS Our study highlights that incomplete excision has led to repeated recurrent epidermoid cyst, but its complete removal with adjuvant radiotherapy has achieved remission of symptoms. Atypical hyperplasia discovered by pathological examination reminds us the possibility of malignant transformation and ensures the necessity of adequate treatment.
Collapse
Affiliation(s)
- Jialin Li
- Department of Orthopedics Oncology, Changzheng Hospital
| | - Ming Qian
- Department of Orthopedics Oncology, Changzheng Hospital
| | | | - Li Zhao
- Nursing School, Second Military Medical University, Shanghai, China
| | - Xinghai Yang
- Department of Orthopedics Oncology, Changzheng Hospital
| | - Jianru Xiao
- Department of Orthopedics Oncology, Changzheng Hospital
| |
Collapse
|
16
|
Funao H, Isogai N, Daimon K, Mima Y, Sugiura H, Koyanagi T, Nakamura M, Matsumoto M, Ishii K. A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature. World J Surg Oncol 2017; 15:131. [PMID: 28716031 PMCID: PMC5513138 DOI: 10.1186/s12957-017-1186-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 06/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia. Case presentation A 67-year-old female presented with a low back pain and left sciatica. Although the patient had experienced occasional mild low back pain for several years, her low back pain markedly worsened 2 months before her visit, as well as newly developed left sciatica resulting in intermittent claudication. She had a history of several abdominal surgeries. All abdominal procedures were performed under general anesthesia with epidural anesthesia in her thoracolumbar spine. Magnetic resonance imaging of her lumbar spine demonstrated an intradural extramedullary spinal cord tumor at the T12–L1 level. Because her symptoms deteriorated, the tumor excision was performed using microscopy. Histological examination of the specimens demonstrated that the cyst walls lined with stratified squamous keratinizing epithelium surrounded by the outer layer of collagenous tissue with the absence of skin adnexa. A diagnosis of epidermoid cysts was confirmed. Her MRI showed complete resection of the tumor, and there was no recurrence at 2-year follow-up. Conclusions In this case report, epidermoid cells might be contaminated into the spinal canal during repetitive epidural anesthesia. The patient was successfully treated by complete resection, and there was no recurrence at 2-year follow-up with a good clinical outcome. However, long-term follow-up is required for a potential risk of tumor recurrence.
Collapse
Affiliation(s)
- Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare Mita Hospital, Minato, Japan. .,Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Minato, Japan. .,Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan.
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare Mita Hospital, Minato, Japan.,Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Minato, Japan
| | - Kenshi Daimon
- Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
| | - Yuichiro Mima
- Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
| | - Hitoshi Sugiura
- Department of Pathology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
| | - Takahiro Koyanagi
- Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare Mita Hospital, Minato, Japan.,Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Minato, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Japan
| |
Collapse
|
17
|
Intramedullary epidermoid cysts in adults: Case report and updated literature review. Neurochirurgie 2017; 63:99-102. [PMID: 28495229 DOI: 10.1016/j.neuchi.2017.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 12/16/2016] [Accepted: 01/14/2017] [Indexed: 11/21/2022]
Abstract
Epidermoid cysts are classical tumors in neurosurgery, but spinal locations are rare and intramedullary locations represent only approximately 80 cases in the literature. Intramedullary epidermoid cysts arise from ectodermic tissue inclusion during neural tube closure. Intramedullary epidermoid cysts are more frequent in young patients and in a thoracic location. We report the case of a 61-year-old patient consulting for bilateral asymmetrical progressive paraparesis and proprioceptive ataxia revealing a T3-T4 exophytic medullar epidermoid cyst. The tumor was surgically removed with a favorable outcome. The capsule was partially removed. The authors present an updated literature review of intramedullary epidermoid cyst diagnosis, management and recommendations.
Collapse
|
18
|
Faheem M, Zeeshan Q, Ojha BK, Chandra A, Singh SK, Srivastava C, Sagar M, Saba NU. Isolated thoracic intramedullary epidermoid cyst - a rare entity. ROMANIAN NEUROSURGERY 2016. [DOI: 10.1515/romneu-2016-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Intramedullary epidermoid cysts of the spinal cord are rare tumours, especially those not associated with spinal dysraphism. Around 60 cases have been reported in the literature. Of these, only 10 cases have had magnetic resonance imaging (MRI) studies. Here, we report a case of isolated intramedullary epidermoid tumour at D2-D3 level. The etiology, pathology, clinical features, MRI characteristics and surgical treatment of such rare intramedullary tumours are discussed.
Collapse
|
19
|
Babayev R, Abbasov B, Ekşi MŞ. Thoracic intramedullary epidermoid cyst-timely fashion diagnosis and treatment. Childs Nerv Syst 2015; 31:793-6. [PMID: 25681950 DOI: 10.1007/s00381-015-2625-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 02/02/2015] [Indexed: 11/30/2022]
Abstract
Epidermoid cysts are composed of stratified squamous epithelium, which develop from inclusion of ectodermal tissue remnants entrapped during primitive neural tube closure period between the 3rd and 5th weeks of gestation. Intramedullary epidermoid cysts (IEC) are very rare in childhood. Eleven cases have been reported previously. Even though it is a rare entity, early diagnosis with timely fashioned surgical treatment has a great influence on patients' symptoms, especially if there are myelopathic findings. In this case report, we demonstrate this fact with a demonstrative clinical case and review radiological, pathological, and surgical perspectives with literature review.
Collapse
Affiliation(s)
- Rasim Babayev
- Department of Neurosurgery, National Oncology Center, Az1012, Şerifzade sok. 10, Baku, Azerbaijan,
| | | | | |
Collapse
|
20
|
Gotecha S, Ranade D, Sharma S, Punia P, Kotecha M. Giant intradural intramedullary epidermoid cyst Report of two cases with varied presentations. Asian J Neurosurg 2015; 9:244. [PMID: 25685236 PMCID: PMC4323983 DOI: 10.4103/1793-5482.146653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We report two cases with giant intramedullary epidermoid cysts in the thoracolumbosacral and lumbosacral regions with varied presentations. Magnetic resonance (MR) imaging of the thoraco lumbar spine in case 1revealed an intramedullary elongated mass extending from T10 to S2 level causing significant widening of the spinal canal while MR imaging of lumbosacral spine in case 2 showed straightening of the lumbar spine and spina bifida at L5 level with conus at L3 and a lobulated long segment intramedullary solid cystic lesion extending from L2 to S2 veterbrae. The lesion was surgically resected and the pathology revealed an epidermoid cyst. Epidermoid cysts of the spinal cord are rare tumours in the adult population which may be congenital or acquired. Symptoms arising from epidermoid cysts vary with the level of involvement. The treatment of epidermoid cysts is surgical and if possible, complete removal is the goal.
Collapse
Affiliation(s)
- Sarang Gotecha
- Department of Neurosurgery, Padmashree Dr. D. Y. Patil Hospital, Pimpri, Pune, Maharashtra, India
| | - Deepak Ranade
- Department of Neurosurgery, Padmashree Dr. D. Y. Patil Hospital, Pimpri, Pune, Maharashtra, India
| | - Shrikant Sharma
- Department of Neurosurgery, Padmashree Dr. D. Y. Patil Hospital, Pimpri, Pune, Maharashtra, India
| | - Prashant Punia
- Department of Neurosurgery, Padmashree Dr. D. Y. Patil Hospital, Pimpri, Pune, Maharashtra, India
| | - Megha Kotecha
- Department of Neurosurgery, Padmashree Dr. D. Y. Patil Hospital, Pimpri, Pune, Maharashtra, India
| |
Collapse
|
21
|
Lao LF, Zhong GB, Liu ZD. Surgical treatment of a sebaceous cyst in the spine region. Spine J 2014; 14:2266-8. [PMID: 24747267 DOI: 10.1016/j.spinee.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/17/2014] [Accepted: 04/09/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Li-Feng Lao
- Department of Orthopaedic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Rd, Shanghai 200127, China
| | - Gui-Bin Zhong
- Department of Orthopaedic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Rd, Shanghai 200127, China
| | - Zu-De Liu
- Department of Orthopaedic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Rd, Shanghai 200127, China
| |
Collapse
|
22
|
Yin H, Zhang D, Wu Z, Zhou W, Xiao J. Surgery and outcomes of six patients with intradural epidermoid cysts in the lumbar spine. World J Surg Oncol 2014; 12:50. [PMID: 24589060 PMCID: PMC3975861 DOI: 10.1186/1477-7819-12-50] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/19/2014] [Indexed: 12/17/2022] Open
Abstract
Study design This was a retrospective study. Objective The 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 data Epidermoid 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. Methods Six 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. Results The 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. Conclusions Although 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.
Collapse
Affiliation(s)
| | | | | | - Wang Zhou
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
| | | |
Collapse
|
23
|
Somasundaram A, Lesser GJ, Mott RT, Hsu W. Malignant transformation of an intramedullary epidermoid cyst in the thoracic region of the spinal cord. J Neurosurg Spine 2013; 19:591-4. [DOI: 10.3171/2013.8.spine13150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Malignant transformation of epidermoid cysts (ECs) to squamous cell carcinomas (SCCs) in the CNS is exceedingly rare and has only been described in intracranial ECs. In this article, the authors describe a 53-year-old man with a history of a previously resected T3–4 EC, who presented with a 2-month history of progressively worsening weakness in the left side of his body. Magnetic resonance imaging revealed an enhancing mass in the T3–4 region, the exact location of the previous cyst. The mass was resected in gross-total fashion, and pathological analysis revealed an SCC. Postoperatively, the patient regained full strength in his lower extremities. After the resection, he received radiotherapy administered at an isodose of 50 Gy. To the authors' knowledge, this is the first reported case of malignant transformation of an intramedullary spinal EC in the literature.
Collapse
Affiliation(s)
| | | | - Ryan T. Mott
- 3Pathology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | | |
Collapse
|
24
|
Intramedullary thoracic spine epidermoid cyst with myelopathic presentations: a report of a rare case. Clin Neurol Neurosurg 2012; 115:841-3. [PMID: 22959213 DOI: 10.1016/j.clineuro.2012.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 07/15/2012] [Accepted: 08/04/2012] [Indexed: 11/20/2022]
|
25
|
Liu H, Zhang JN, Zhu T. Microsurgical treatment of spinal epidermoid and dermoid cysts in the lumbosacral region. J Clin Neurosci 2012; 19:712-7. [PMID: 22436108 DOI: 10.1016/j.jocn.2011.07.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 06/27/2011] [Accepted: 07/03/2011] [Indexed: 11/24/2022]
Abstract
The aim of this study was to evaluate the characteristics and surgical outcome of spinal epidermoid and dermoid cysts in the lumbosacral spine. We reviewed 26 patients with spinal epidermoid and dermoid cysts (15 epidermoid and 11 dermoid) treated between October 2000 and December 2010. The latter 15 patients of this series underwent neurophysiological monitoring during surgery. Gross total resection of the tumour was achieved in 46.2% of patients, and 53.8% underwent subtotal resection. In 14 patients, the tumour capsule adhered so tightly to the neural structures that a section of the capsule remained in situ. After surgery, the Japanese Orthopaedic Association score improved in 80.8% of patients, remained stable in 15.4%, and declined in 3.8%. The average follow-up period was 53 months. Three patients developed recurrence of the tumour and 20 patients resumed a normal working life. Microsurgical techniques and intraoperative neurophysiological monitoring are practical and reliable methods for radical removal of spinal epidermoid and dermoid cysts that involve the conus medullaris and cauda equina.
Collapse
Affiliation(s)
- Hui Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, 154 An-Shan Road, Tianjin 300052, China
| | | | | |
Collapse
|
26
|
Lipitz L, Rylander H, Pinkerton ME. Intramedullary Epidermoid Cyst in the Thoracic Spine of a Dog. J Am Anim Hosp Assoc 2011; 47:e145-9. [DOI: 10.5326/jaaha-ms-5583] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 5 yr old female spayed mastiff was evaluated for a 3–4 mo history of paraparesis and 3 days of acutely worse paraparesis and incontinence. On magnetic resonance imaging, a spinal cord lesion was present at the ninth thoracic vertebra. The lesion was hyperintense on T2-weighted images (T2-W), and a hyperintense rim was present on T1-weighted postcontrast images. Histologic examination showed a cystic mass lined by squamous epithelial cells. Histopathologic diagnosis was an intramedullary epidermoid spinal cyst. Epidermoid cyst should be a differential diagnosis in young dogs with a myelopathy and an intramedullary spinal cord lesion on magnetic resonance imaging examination.
Collapse
Affiliation(s)
- Lisa Lipitz
- Department of Medical Sciences (L.L., H.R.) and Department of Pathobiological Sciences (M.P.), Veterinary Medical College of Wisconsin, Madison, WI
| | - Helena Rylander
- Department of Medical Sciences (L.L., H.R.) and Department of Pathobiological Sciences (M.P.), Veterinary Medical College of Wisconsin, Madison, WI
| | - Marie E. Pinkerton
- Department of Medical Sciences (L.L., H.R.) and Department of Pathobiological Sciences (M.P.), Veterinary Medical College of Wisconsin, Madison, WI
| |
Collapse
|
27
|
Kumar A, Singh P, Jain P, Badole CM. Intramedullary spinal epidermoid cyst of the cervicodorsal region: A rare entity. J Pediatr Neurosci 2011; 5:49-51. [PMID: 21042510 PMCID: PMC2964782 DOI: 10.4103/1817-1745.66675] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Intramedullary spinal epidermoid cysts are rare, with only few cases having been reported in the literature. We are reporting a case of a 10-year-old female child who presented with symptoms of meningitis with progressive paraparesis. Magnetic resonance imaging of the spine revealed an intramedullary epidermoid cyst from C6 to D5. Near-total excision of the tumor was performed. Histopathological report confirmed the diagnosis of epidermoid cyst. The patient showed progressive recovery.
Collapse
Affiliation(s)
- Ashok Kumar
- Department of Orthopedics and Traumatology, M.G.I.M.S., Sewagram - 442 102 Wardha, Maharashtra, India
| | | | | | | |
Collapse
|
28
|
Abstract
Nontumor lesions of the spinal cord and spine include developmental disorders, cystic tumor-like lesions, vascular disorders, infective diseases, demyelinating diseases, degenerative diseases, metabolic and toxic disorders, and spinal cord injury. In addition, diseases of the spine and extradural spaces secondarily cause spinal cord injury. Aside from tumors, these include developmental abnormalities, inflammatory diseases, nontumor space-occupying lesions, and tumor-like lesions such as lipomas, vascular malformations, and cysts. Awareness is required of hemostatic agents used during surgery and subsequently presenting as space-occupying lesions, which have to be differentiated from recurrent lesions. On the therapeutic front, stem cell transplantation into spinal cord for treatment of neurodegenerative disorders, spinal cord injury, and multiple sclerosis is a challenging prospect.
Collapse
Affiliation(s)
- Medha Tatke
- Department of Pathology, G.B. Pant Hospital, New Delhi, India.
| |
Collapse
|
29
|
A conus medullaris cystic mass causing cauda equina syndrome in a 33-year-old man. J Clin Neurosci 2009. [DOI: 10.1016/j.jocn.2009.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|