Iatrogenic Intraspinal Epidermoid Tumor: Case Report

Abstract

Iatrogenic spinal epidermoid tumors are extremely rare and may be caused by skin fragments which were implanted in the spine as a result of a trauma or lumbar puncture. Due to the time lag between the lumbar puncture and the development of a symptomatic tumor, this relationship is often overlooked and can cause a delay in the proper diagnosis. Here, we report a rare case of an intraspinal epidermoid tumor, which developed 7 years after a lumbar puncture in a 12-year-old boy, who presented with back pain and radiating pain to the posterior of both thighs. A total excision of the tumor via L₃–L₄ hemilaminectomy yielded a good functional recovery.

Intraspinal Epidermoid Tumor of the Cauda Equina Region

“…Contrast enhancement is uncommon, and they sometimes shows rim enhancement around the periphery of the mass, which indicates an inflammatory response involving the cyst wall. 25,45 The differential diagnosis consists of arachnoid cyst, primary tumors such as Schwannoma, and intradural extramedullary tumors in children, including neurofibromas, meningiomas, lipomas, dermoids, and teratomas. 8,25,46 Because the characteristics of epidermoid tumors vary widely, preoperative diagnosis is difficult.…”

Spinal epidermoid cyst with sudden onset of paraplegia

“…The genesis of congenital spinal epidermoids is an anomalous implantation of ectodermal cells during the closure of the neural tube between the third and fifth week of embryonic life. [2][3][4] These lesions are found most commonly in the subdural, extramedullary space of the lumbosacral region. [4] In a series of 15 patients with spinal intradural dysembryogenetic tumors, the tumor site was the thoracic region in three cases, the lumbar cord and conus in six, the cauda equina in four and the filum terminale in two.…”

Comparing tissue coring potentials of hollow needles without stylet and caudal needles with stylet

“…It is significant because it carries the potential that the transported tissue may proliferate in its new location and cause clinical problems [1]. The possibility of epidermoid tumour development after lumbar puncture has been proposed in several studies since 1950s [2][3][4][5].…”