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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Published on: July 5, 2021

Iatrogenic intraspinal epidermoid cyst.

Min Ho Park¹, Tach Geun Cho¹, Jae Gon Moon¹

¹Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Korean Journal of Spine

|October 28, 2014

Summary

This case study highlights an iatrogenic epidermoid cyst, a rare spinal tumor, potentially caused by multiple lumbar punctures. Prompt surgical removal led to significant neurological recovery in the patient.

Keywords:

Epidermoid cyst Iatrogenic Lumbar puncture

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Area of Science:

Neurosurgery
Neurology
Spinal Tumors

Background:

Epidermoid cysts are typically congenital spinal anomalies.
Iatrogenic causes, though rare, can lead to epidermoid cyst development.
Intradural extramedullary tumors present diagnostic and therapeutic challenges.

Purpose of the Study:

To report a rare case of an iatrogenic spinal epidermoid cyst.
To investigate the potential link between lumbar punctures and epidermoid cyst formation.
To describe the surgical management and outcomes of such a rare tumor.

Main Methods:

Case report of a 21-year-old female with low back pain and neurological deficits.
Magnetic resonance imaging (MRI) to identify the intradural extramedullary mass at L4-L5.
Surgical gross total tumor removal via laminectomy.
Histopathological confirmation of epidermoid cyst.

Main Results:

A 1.8×1.6×4 cm well-circumscribed intradural extramedullary mass was identified.
Gross total removal of the fragile, gray-colored tumor was achieved.
Histology confirmed a non-malignant epidermoid cyst.
The patient experienced progressive and remarkable neurological recovery post-surgery.

Conclusions:

The patient's history of multiple lumbar punctures suggests an iatrogenic origin for the spinal epidermoid cyst.
Surgical intervention can lead to significant recovery from symptomatic spinal epidermoid cysts.
This case underscores the importance of considering iatrogenic factors in the etiology of spinal tumors.