Ruptured spinal dermoid cyst with disseminated intracranial fat droplets

Fat droplets in the cerebrospinal fluid (CSF) is a well-known complication of ruptured intracranial dermoid tumours. We report an unusual case of a ruptured spinal dermoid tumour. MR images showed a tethered spinal cord and an intramedullary fat-containing mass. Fat droplets were revealed in the ventricles and the cisternal spaces on brain CT and brain MR. In the English literature, a ruptured spinal dermoid tumour accompanying a tethered spinal cord is extremely rare.

Spontaneous rupture of spinal dermoid cyst with disseminated lipid droplets in central canal and ventricles

Free fat in the ventricular space is a rare but well recognized complication of ruptured tumour of dermal origin. However, only 1 patient of spontaneous rupture of spinal dermoid tumour with disseminated fat in the central canal and ventricles has been described in the literature. The authors report an extremely rare case of ruptured intraspinal dermoid and passage of free fatty droplets via the patent central canal to the intracranial CSF space. The detailed clinical presentation, radiological findings, and review of the literature are presented. Despite being rarely reported, spinal dermoid cyst can rupture spontaneously, and free fat disseminate into the ventricles, and in extremely rare cases, fat can enter into the central canal. It is underlinerd that a prompt detection, with the help of MRI is essential in cases of spinal dermoid tumour cyst, with sudden deterioration in neurological condition, keeping in mind, the possibility of free fat in the central canal.

Isolated central canal rupture of spinal dermoid: report of two cases

We report two cases of lumbar spinal dermoid cysts with asymptomatic rupture and migration of free fat droplets into the central canal. No fatty droplets were seen within the lumbar subarachnoid space. The presence of fat droplets within the central canal is unusual because the central canal is rudimentary in adults. We suggest that hydromyelia secondary to tumour and specific tumour morphology might facilitate the selective rupture of dermoids into the central canal. We recommend a follow up of these patients to detect any possible intracranial migration of fat droplets and resultant complications.

Rupture of spinal dermoid tumors with spread of fatty droplets in the cerebrospinal fluid pathways

Cranial and spinal MRI was carried out at 0.5 or 1.5 T in five patients with spinal dermoid tumours. Free fatty material was appreciated within the normally communicating cerebrospinal fluid pathways in all five cases and in one case fat droplets were also observed within a dilated central canal of the spinal cord. While dissemination of lipid within the subarachnoid space and ventricles is easily understandable, the presence of lipid droplets within the central canal is more difficult to explain, since the central canal is only potential in the adult. When a dermoid tumor is suspected, we recommend MRI of the entire central nervous system, to detect possible leakage of fat from rupture of a cystic portion of the tumour.