Intraspinal epidermoid cyst

Abstract

An intraspinal epidermoid cyst occurring in the lumbo-sacral region of a 38-year old man with congenital spina bifida occulta is described. Relevant literature on the subject is reviewed.

Primary lumbar epidermoid tumor mimicking schwannoma

“…[1][2][3][4][5][6] They occur most commonly in the intradural, extramedullary space of the lumbosacral region; true intramedullary location is rare. 2,4,5,[8][9][10]12,13,15 The incidence of this has decreased significantly in the last 25 years and may be prevented by using a fine needle with a stylet for lumbar puncture. The more common is an anomalous implantation of ectodermal cells during closure of the neural tube between the third and fifth week of embryonic life.…”

Intraspinal Epidermoid Tumor of the Cauda Equina Region

“…6 A search of the English literature published after 1962 revealed 74 cases of intraspinal epidermoid tumor of the cauda equina region; including the present series, a total of 81 cases has been reported since 1962. [1][2][3][4][5]7,8, Of these 81 more recent cases, 48 (59%) were thought to be acquired, with events of epidermal cell implantation (46 cases, lumbar puncture; 2 cases, surgery for meningocele). Thus, a total of 134 patients with intraspinal epidermoid tumor of the cauda equina region has been reported so far (52 congenital: male 24 cases, female 22 cases, not available 6 cases; 82 acquired patients with no previous information available about events that could have resulted in epidermal cell implantation were classified into the congenital group) ( Table 3).…”

“…1 The association with other epidermal and osseous abnormalities, such as spina bifida, hemivertebrae, myelomeningocele, diastematomyelia, syringomyelia, and cutaneous and dermal defects in the form of pilonidal and dermal sinuses, confirms the congenital origin of the tumor. 2,3 Conversely, the pathomechanism of acquired epidermoid tumor is thought to be mainly iatrogenic, by implantation of epidermal cells into the spinal canal during diagnostic or therapeutic lumbar puncture, lumbar anesthesia, discography, or surgery, or bullet wounds. [3][4][5] Spinal epidermoid tumor is reported to account for about 1% of all primary spinal tumors, and 17% of primary spinal tumors during the first year of life, decreasing to a rate of 13% for the first 15 years.…”

“…2,3 Conversely, the pathomechanism of acquired epidermoid tumor is thought to be mainly iatrogenic, by implantation of epidermal cells into the spinal canal during diagnostic or therapeutic lumbar puncture, lumbar anesthesia, discography, or surgery, or bullet wounds. [3][4][5] Spinal epidermoid tumor is reported to account for about 1% of all primary spinal tumors, and 17% of primary spinal tumors during the first year of life, decreasing to a rate of 13% for the first 15 years. 2 Although Manno et al 6 reviewed 90 cases of intraspinal epidermoid tumors, their study was published in 1962.…”

A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature

“…Congenital spinal ECs are thought to have arisen from aberrant ectodermal cells during closure of the neural tube in the embryonic period, and spinal ECs in the conus medullaris region were reported to occur as an intramedullary tumor [5–7]. Spina bifida, spinal dysraphisms, scoliosis and cutaneous/dermal defects are often associated with congenital ECs [2, 7–9]. In contrast, acquired spinal ECs are mostly caused by trauma or iatrogenic procedures, such as lumbar punctures [10, 11].…”