Intramedullary dermoid cyst infection mimicking holocord tumor: should radical resection be mandatory?—a case report

Abstract

Holocord spinal abscesses are a rare entity. The source of the disease can be hemopoietic spread or contagious spread. The dermal sinus tract is major risk factor for contagious spread. The major hemopoietic sources are urogenital infection, endocarditis, and infective lung diseases. The hemopoietic spread is a more common source for pediatric patients. The thoracolumbar region is the most common site of involvement. Spinal infection has a tendency to extend longitudinally throughout spinal fibers. The pathogenesis of the holocord edema or syrinx is uncertain. The underlying etiology may be inflammation, infection, and associated venous congestion within the spinal canal. Also, CSF circulation alteration due to arachnoiditis may be another etiological factor. The most important entities on outcome are appropriate surgical treatment and antibiotic administration.

An infected dermoid cyst without a sinus tract: A rarity mimicking a spinal tumor

“…[11] At the short-term follow-up, a significant improvement in limb power was reported but there was no improvement in bladder and bowel functions. [23] Literature search reveals, unlike in our case, long-term follow-up has not been reported even in a single patient. Our case highlights that even after a long-term follow-up of about 10 years, there is no radiological evidence of recurrence.…”

Intramedullary abscess at thoracolumbar region transmitted from infected dermal sinus and dermoid through retained medullary cord

“…Intramedullary abscesses often leave permanent and severe neurological sequelae and require early surgical intervention. [ 1 , 2 , 7 , 19 ] There were fortunately only mild neurological sequelae in this case, but the diagnosis of an intramedullary abscess was slightly delayed. One reason for this is that the response to antibiotic administration for the initial 2 weeks was good.…”

“…This can cause discharging sinus, local erythema, and induration as well as repeated meningitis or neurological dysfunction associated with infected inclusion tumors such as dermoid or epidermoid cysts. [ 1 , 2 , 7 , 10 , 19 ] Spinal intramedullary abscesses are the rarest but most serious complication of a CDS, which may lead to permanent and serious neurological deficits. [ 1 , 2 , 7 , 10 , 19 ] Fifty cases of intramedullary abscesses due to a CDS in the pediatric age group were reported in 2019.…”

“…[ 1 , 2 , 7 , 10 , 19 ] Spinal intramedullary abscesses are the rarest but most serious complication of a CDS, which may lead to permanent and serious neurological deficits. [ 1 , 2 , 7 , 10 , 19 ] Fifty cases of intramedullary abscesses due to a CDS in the pediatric age group were reported in 2019. [ 19 ]…”

Dermoid Cyst of the Conus Medullaris in Adult: A Case Report and Review of the Literature

“…3(3).2020 glands [3,4]. They often have a single cystic component with loose islands of keratin, and cutaneous appendages such as hair follicles, hair, sebaceous and sweat glands, as well as sebum [11][12][13]. The most widely accepted theory according to the "developmental theory" is that the DC arises from the cell rests that result from defective closure of the neural tube between the third and fourth week of fetal life.…”