Epidermoid Cyst of the Thoracic Spine: A Rare Case

Abstract

Intraspinal epidermoid cyst is a rare tumor. The incidence in adults is lesser than 1% and in children lesser than 3%. Epidermoid cyst is predominantly seen at the dorsal spinal level. A large percentage of epidermoid cysts are intradural extramedullary. Intramedullary epidermal cysts are rarer, with about 70 cases reported in the literature. These may be congenital or acquired with known association with spinal dysraphism. We hereby report a case of thoracic epidermoid cyst in a 22-year-old male with an extramedullary exophytic component and intramedullary cyst with accompanying split cord malformation at the level of lesion.

Concurrent Thoracic Spinal Intradural Extramedullary Epidermoid and Neurenteric Cyst in a Spinal Dysraphism Child

“…This explains their midline dorsal to cord location and common association with spinal dysraphism. Congenital epidermoid may be intramedullary or extramedullary, whereas acquired epidermoid is usually extramedullary [1, 3]. Acquired epidermoid cyst develops due to traumatic and iatrogenic penetration of skin fragments following lumbar puncture or meningomyelocele repair, which gradually progresses leading to a delayed presentation (latency of many years) [4].…”

“…Intraspinal epidermoid cysts are rare benign slowgrowing paediatric spinal lesions with congenital or acquired origin. Congenital ones, often seen in spinal dysraphism patients are aberrant ectodermal inclusion cysts DOI: 10.1159/000511091 formed during neural tube closure (fourth week of embryonic life) and may be intramedullary, extramedullary, or combined; whereas acquired ones are usually extramedullary in location [1]. Intraspinal neurenteric cysts (NECs) are congenital mucin-producing foregut duplication cysts resulting from ectoderm-endoderm separation failure during the third week of embryonic life, and majority of them are ventral to cord and intradural extramedullary in location.…”

Spinal intramedullary epidermoid cysts: Three case presentations and literature review

“…[16,24,36] Detailed information about the gender, age, and location of the tumor is shown in separately [Table 2]. Scholz et al [35] 1994 M 32 T3-T4 Paraparesis Laminectomy Good Jadhav et al [17] 1999 F 12 C7-T2 Quadriparesis Laminectomy Good Chandra et al [8] 2000 F 18 T4-T5 Paraparesis Laminectomy Good Chandra et al [8] 2000 F 28 Conus Paraparesis and incontinence Laminectomy Good Amato et al [4] 2002 F 21 T3-T4 Paraparesis Laminectomy Good Rocha et al [33] 2003 F 15 T2-T4 Monoparesis Laminectomy Good Ferrara et al [13] 2003 F 13 T10-T11 Incontinence Laminectomy Fair Cataltepe et al [7] 2004 M 6 C1-T5 Quadriparesis Laminoplasty Good Kumar and Sing [21] 2oo4 M 4 Conus Paraparesis and incontinence NM Good Kumar and Sing [21] 2004 F 14 T3-T5 Paraparesis NM Good Lai et al [22] 2005 M 49 Conus Monoparesis+incontinence Laminectomy Fair Moon et al [26] 2006 F 43 Conus Incontinence Laminectomy Poor Cincu et al [9] 2007 M 27 T5-T6 Monoparesis Laminectomy Good Ogden et al [28] 2007 F 61 C3-T1 Paraparesis Laminectomy Fair Lee et al [23] 2008 M 53 Conus Paraparesis and incontinence Laminectomy Good Gonzalvo et al [14] 2009 M 40 C7-T2 Monoparesis+incontinence Laminectomy Good Kumar et al [20] 2010 F 10 C6-T5 Paraparesis+meningitis Laminectomy Fair Brohi et al [6] 2010 M 33 T5-T6 Paraplegia Laminectomy Poor Agarwal et al [1] 2011 F 40 C2-C3 Quadriparesis Laminectomy Good Fereydoonian et al [12] 2012 M 40 T4 Paraparesis Laminectomy Good Yoon et al [37] 2013 F 55 C4-T10 Paraplegia Laminectomy Good Gotecha et al [15] 2014 F 23 Conus Paraparesis+incontinence Laminectomy Good Babayev [5] 2015 F 14 T2-T3 Monoparesis Laminectomy Good Ohara et al [29] 2015 F 63 Conus Paraparesis+incontinence Laminectomy Good Mishra et al [25] 2015 M 14 T4-T5 Paraparesis Laminectomy Good Jain et al [18] 2016 M 22 T2 Mild paraparesis Laminectomy Good Elsebaey and Elgohary [10] 201...…”

“…ey are hyperintense on T2-weighted image due to the keratin content of the cyst. [1,2,[4][5][6][7][8][9][10][12][13][14][15]17,18,[20][21][22][23][25][26][27][28][29]33,35,37] e diffusion-weighted MR best demonstrates epidermoid cyst homogeneous hyperintensity. [11,19] With these characteristic features, IECs can be easily differentiated from intramedullary lipoma, teratoma, and arachnoid cyst.…”

Epidermoid Causing Split Cord Malformation in a Case of Jarcho Levin Syndrome (JLS)

“…Only few cases of JLS with diplomyelia have been reported in the literature [1,2]. Spinal epidermoids are uncommon [3].…”