Thoracic dorsal dermal sinus with secondarily infected intramedullary dermoid cyst

Abstract

Dorsal dermal sinus (DDS) is an uncommon type of occult spinal dysraphism most often located in the lumbar region. Patients present either due to secondary infection or compression of neural structures by an associated dermoid or epidermoid cyst. We report a rare case of 2-year-old child who presented with progressive paraparesis with magnetic resonance imaging of spine showing a thoracic DDS with an infected intramedullary dermoid cyst. Partial excision of the dermoid cyst and resection of the sinus opening was done with partial clinical improvement postsurgery.

Type IV dermoid sinus, intramedullary dermoid cyst and spina bifida in a Cane Corso

“…To remove this intramedullary lesion, the sinus was carefully dissected, followed by a partial durectomy and a myelotomy performed with microscope assistance. As much as possible of the cystic lesion was freed from the spinal cord parenchyma and removed, but excision may not have been complete due to dense adhesions, such as described in human medicine (Mishra & Panigrahi 2014, Patwari et al 2019.…”

“…Prognosis remains guarded for return to normal function given the intramedullary involvement of the disease and the myelotomy performed. Recurrence is also described in human medicine if the dermoid cyst has not been completely removed (Mishra & Panigrahi 2014, Patwari et al 2019.…”

“…Another originality of this case is the association of the dermoid sinus with an intramedullary dermoid cyst. Although few cases of isolated dermoid or epidermoid cyst of the spinal cord have been described in cats (Henderson et al 1993) and dogs (Tomlinson et al 1988, Shamir et al 1999, Lipitz et al 2011, association with a dermoid sinus has never been reported previously in veterinary medicine and is only rarely described in human medicine (Mishra & Panigrahi 2014, Patwari et al 2019.…”

“…2011), association with a dermoid sinus has never been reported previously in veterinary medicine and is only rarely described in human medicine (Mishra & Panigrahi 2014, Patwari et al . 2019).…”

“…As much as possible of the cystic lesion was freed from the spinal cord parenchyma and removed, but excision may not have been complete due to dense adhesions, such as described in human medicine (Mishra & Panigrahi 2014, Patwari et al . 2019).…”