Intradural Extramedullary Epidermoid Cyst - A Case Report -

Kwang Hwan Jung; Sung Do Cho; Sang Hun Ko; Chae Chil Lee; Yun Suck Yeom; Sang Woo Kim; Hang Ki Kang; Jae-Ryong Cha

doi:10.4184/jkss.2015.22.1.26

Journal List > J Korean Soc Spine Surg > v.22(1) > 1076072

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Jung, Cho, Ko, Lee, Yeom, Kim, Kang, and Cha: Intradural Extramedullary Epidermoid Cyst - A Case Report -

Case Report

Journal of Korean Spine Surg 2015;22(1):26-30.

Published online: 21 March 2015

DOI: https://doi.org/10.4184/jkss.2015.22.1.26

Intradural Extramedullary Epidermoid Cyst - A Case Report -

Kwang Hwan Jung, M.D., Sung Do Cho, M.D., Sang Hun Ko, M.D., Chae Chil Lee, M.D., Yun Suck Yeom, M.D., Sang Woo Kim, M.D., Hang Ki Kang, M.D., Jae-Ryong Cha, M.D.

Department of Orthopedic Surgery, Ulsan University Hospital, College of Medicine, Ulsan University

Corresponding author: Jae-Ryong, Cha, M.D. 290-3 Cheonha-Dong, Dong-Ku, Ulsan 682-714 Korea Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine TEL: +82-52-250-7129, FAX: +82-52-235-2823 E-mail: jrcha@uuh.ulsan.kr

Received 23 December 2014 Revised 21 January 2015 Accepted 12 March 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Objectives

To report a rare case of epidermoid cyst in the spinal canal.

Summary of Literature Review

Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer.

Material and Methods

A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6 –T8 level. The cystic mass was excised after durotomy using a posterior approach.

Results

We confirmed the presence of an epidermoid cyst for histopathology.

Conclusion

Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.

Keywords: Intradural, Epidermoid cyst

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Fig. 1.

MRI finding of lumbar spine (A) Cystic mass with hyper-intense signal area in T2 weighted image at the T7. (B) Tumor mass occupies the almost entire canal in axial views.

Fig. 2.

Operative Findings : Huge irregularly shaped nodular tumor mass wall is seen, when the dura was open.

Fig. 3.

Operative Findings : 1x1.5 size mass is excised.

Fig. 4.

Sagittal and axial magnetic resonance images 1 weeks after surgery reveal normalization of the previously compressed spinal cord.

Fig. 5.

(A) The microscopic finding shows keratin laid down by the well-developed squamous epithelium. The stroma reveals abun-dant skin appendages. But no sweat gland and hair follicles are seen. (B) The well-developed squamous epithelia are shown. The underlying stroma demonstrates loose mesenchymal tissue(x100).

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