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Intramedullary epidermoid cysts in adults: Case report and updated literature review
T Graillon1, P Rakotozanany1, M Meyer1
1Service de neurochirurgie, Pr-Dufour hôpital La Timone adultes, Aix-Marseille université, AP-HM, 264, rue St-Pierre, 13005 Marseille, France.
Insights
Spinal epidermoid cysts are rare neurosurgical tumors. This case report details a T3-T4 intramedullary epidermoid cyst in an adult, highlighting diagnosis and surgical management.
Area of Science:
- Neurosurgery
- Neuropathology
- Spinal Cord Tumors
Background:
- Epidermoid cysts are uncommon spinal tumors, with intramedullary locations being exceptionally rare, accounting for approximately 80 reported cases.
- These cysts originate from ectodermal inclusions during embryonic neural tube development.
- Intramedullary epidermoid cysts predominantly affect younger individuals and are often found in the thoracic spine.
Observation:
- A 61-year-old patient presented with progressive, asymmetrical paraparesis and proprioceptive ataxia.
- Imaging revealed an exophytic epidermoid cyst at the T3-T4 medullary level.
- The patient underwent surgical resection of the cyst, with partial capsule removal.
Findings:
- Surgical removal of the T3-T4 intramedullary epidermoid cyst resulted in a favorable clinical outcome.
- The case contributes to the limited literature on adult-onset, thoracic intramedullary epidermoid cysts.
- Histopathological analysis confirmed the diagnosis of an epidermoid cyst.
Implications:
- This case underscores the importance of considering rare spinal tumors in the differential diagnosis of myelopathy.
- Effective surgical management can lead to positive outcomes, even in challenging intramedullary locations.
- Further literature review provides updated insights into the diagnosis, management, and recommendations for intramedullary epidermoid cysts.
Abstract:
Epidermoid cysts are classical tumors in neurosurgery, but spinal locations are rare and intramedullary locations represent only approximately 80 cases in the literature. Intramedullary epidermoid cysts arise from ectodermic tissue inclusion during neural tube closure. Intramedullary epidermoid cysts are more frequent in young patients and in a thoracic location. We report the case of a 61-year-old patient consulting for bilateral asymmetrical progressive paraparesis and proprioceptive ataxia revealing a T3-T4 exophytic medullar epidermoid cyst. The tumor was surgically removed with a favorable outcome. The capsule was partially removed. The authors present an updated literature review of intramedullary epidermoid cyst diagnosis, management and recommendations.
