Spinal Dermoid Cyst with Spontaneous Rupture into the Syrinx Cavity Alone

Spinal dermoid cysts are uncommon tumors, and their spontaneous rupture into the syrinx cavity alone is extremely rare. The treatment strategy for this condition has not been described.

We report 4 patients with lumbar spinal dermoid cysts and spontaneous rupture. The ruptured contents were all located at the cervicothoracic intramedullary section, leading to a lipid syrinx. There were 2 male and 2 female patients, with ages ranging from 23 to 36 years old (median 30 years).

The main preoperative complaints of 3 patients were associated with the cervicothoracic syrinx, and syrinx aspiration surgery was performed. Two of those patients underwent subsequent lumbar dermoid cyst resection surgery. The fourth patient's initial complaint was caused by the lumbar dermoid cyst; thus, tumor resection surgery was performed first. Years after surgery, the fourth patient also presented with symptoms associated with the cervicothoracic intramedullary lipid syrinx, and syrinx aspiration surgery also was conducted. All patients had good recovery.

Staging operations should be considered according to the patient's symptoms. Syrinx aspiration surgery is an effective treatment for the symptomatic lipid syrinx.