Extensive Intradural Epidermoid Cysts with Cauda Equina Syndrome in the Lumbosacral Spine - Case Report -

Tae-Keun Ahn; Dong-Eun Shin; Young Woo Kwon; Sang-June Lee

doi:10.4184/jkss.2016.23.2.121

Journal List > J Korean Soc Spine Surg > v.23(2) > 1076092

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Ahn, Shin, Kwon, and Lee: Extensive Intradural Epidermoid Cysts with Cauda Equina Syndrome in the Lumbosacral Spine - Case Report -

Case Report

Journal of Korean Spine Surg 2016;23(2):121-126.

Published online: 30 June 2016

DOI: https://doi.org/10.4184/jkss.2016.23.2.121

Extensive Intradural Epidermoid Cysts with Cauda Equina Syndrome in the Lumbosacral Spine - Case Report -

Tae-Keun Ahn, M.D., Dong-Eun Shin, M.D., Young Woo Kwon, M.D., Sang-June Lee, M.D.

Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University, Korea

Corresponding author: Dong-Eun Shin, M.D. Department of Orthopedic Surgery, CHA Bundang Medial Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi, 13496, Korea TEL: +82-31-780-5289, FAX: +82-31-708-3578 E-mail: shinde@cha.ac.kr

Received 6 November 201516 November 2015 Accepted 4 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) 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 extensive epidermoid cysts in the lumbosacral spine.

Summary of Literature Review

The intradural epidermoid cyst with extensive involvement is rare, and previous reports have reported only extensive intramedullary epidermoid cysts.

Materials and Methods

A 75-year-old male presented with progressive motor weakness of both extremities beginning 3 days prior. MRI showed extensive intradural extramedullary epidermoid cysts in the lumbosacral region. We performed total laminectomy from the L1 to the L5 level, and the cystic mass was removed.

Results

We confirmed the epidermoid cyst on histopathologic examination.

Conclusions

Extensive extramedullary epidermoid cysts are difficult to remove completely. Attempting complete removal may result in neurological deficit. Therefore, when surgical intervention is planned, the poor postoperative prognosis should be taken into consideration.

Keywords: Cauda equina syndrome, Intradural-extramedullary, Epidermoid cyst

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Fig. 1.

Preoperative T1-weighted MRI sagittal (A) and T2-weighted MRI sagittal (B) images show an extramedullary elongated mass extending from the L1 to L5 level without widening of the spinal canal.

Fig. 2.

Enhanced T1-weighted sagittal MRI reveals a thin rim enhancement around the mass.

Fig. 3.

(A-B) Intraoperative images show intradural epidermoid cyst.

Fig. 4.

Gross photo (A) and histopathological image (B, H&E stain, 1×) show a Calcified bone.

Fig. 5.

A histopathological image (A, H&E stain, 1×) and another histopathological image (B, H&E stain, 4×) show an epidermoid cyst.

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