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Abstract

Intradural epidermoid cysts of the spine are rare congenital lesions. Their etiology is thought to stem from ectodermal remnants during embryonic development. They result in a diverse clinical presentation, often marked by an insidious onset and variable neurological deficits. Timely diagnosis is crucial for optimizing patient outcomes. We present the case of a 10-year-old male child presenting a six-month history of worsening back pain, intermittent leg weakness, and urinary incontinence. The physical examination revealed tenderness over the lower thoracic and lumbar spine, lower limb weakness, hyperreflexia, and sensory deficits. The diagnostic work-up, including cerebrospinal fluid analysis and magnetic resonance imaging, confirmed the presence of an intradural epidermoid cyst in the lumbosacral region. Surgical excision resulted in complete resection, with subsequent improvement in neurological deficits. This pediatric case underscores the importance of maintaining a high index of suspicion for unexplained neurological deficits. Characteristic imaging findings played a pivotal role in the diagnosis, guiding successful surgical intervention and achieving favorable outcomes.

Introduction

Intradural epidermoid cysts of the spine are rare congenital lesions characterized by the presence of stratified squamous epithelium and keratin debris within the spinal canal. These cysts account for less than 1% of all spinal tumors, making them an uncommon yet clinically significant entity [1]. While their etiology remains unclear, current literature suggests that these cysts arise from ectodermal remnants during embryonic development. Clinical manifestations of spinal intradural epidermoid cysts are diverse, often presenting insidiously with symptoms such as back pain, radicular pain, and motor or sensory deficits. The compressive effects on adjacent neural structures, coupled with the potential for chemical meningitis due to cyst contents released into the cerebrospinal fluid, contribute to the variable clinical phenotype [1]. Timely diagnosis and intervention are imperative for optimizing patient outcomes. We present the case of a previously healthy child with an intradural spinal epidermoid cyst in the lumbosacral region.

Case Presentation

A 10-year-old male child presented to the pediatric neurosurgery clinic with a six-month history of progressively worsening back pain, intermittent leg weakness, and occasional urinary incontinence. There was no history of fecal incontinence. The patient's parents reported no history of trauma, febrile illnesses, or other significant medical conditions. Additionally, there was no family history of neurologic disorders or congenital anomalies. The child's developmental milestones were age-appropriate, and he had not experienced...(More)

For more info please read, A Pediatric Case of Spinal Intradural Epidermoid Cyst: A Rare Encounter, by Cureus