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Sacral epidermoid cyst communicating with the spinal CSF canal
Insights
A rare presacral epidermoid cyst connected to the spinal canal was surgically removed from a 6-year-old girl. This case highlights unusual meningitis symptoms, including high cerebrospinal fluid cholesterol, in children with spinal epidermoid cysts.
Area of Science:
- Neuroscience
- Pediatric Surgery
- Pathology
Background:
- Presacral epidermoid cysts are rare congenital tumors.
- Communication between the cyst and the spinal canal presents unique diagnostic challenges.
- Meningitis can be an atypical presentation of spinal epidermoid cysts.
Observation:
- A 6-year-old girl presented with symptoms mimicking meningitis.
- Cerebrospinal fluid analysis revealed squamous cells, cholesterin crystals, and elevated cholesterol levels.
- Myelography confirmed a presacral epidermoid cyst with spinal canal communication.
Findings:
- The presacral epidermoid cyst measured 4.5 x 6.0 x 4.0 cm.
- The cyst was successfully and completely excised surgically.
- Histopathological analysis confirmed the epidermoid cyst diagnosis.
Implications:
- This case underscores the importance of considering spinal abnormalities in pediatric meningitis.
- Elevated CSF cholesterol can be a diagnostic marker for epidermoid cysts.
- Surgical excision is the primary treatment for symptomatic spinal epidermoid cysts.
Abstract:
A 6-year-old girl was found to show a presacral epidermoid cyst which had a communication with the spinal canal. The patient was admitted as a case of meningitis, but squamous cells and cholesterin crystals were observed in the cerebrospinal fluid (CSF), and the CSF cholesterol level was very high. Diagnosis was established by myelography, and a cyst measuring 4.5 x 6.0 x 4.0 cm wide was totally excised surgically. A comparative discussion of this case and other reported cases of dermoid and epidermoid cysts in the central nervous system is given.