Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma

Sanjay Kumar; Krishan Kumar Yadav; Saurabh Kumar Verma

doi:doi:10.11648/j.cnn.20180203.12

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Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma

Sanjay Kumar, Krishan Kumar Yadav, Saurabh Kumar Verma

Published in Clinical Neurology and Neuroscience (Volume 2, Issue 3)

Received: 18 December 2018 Accepted: 3 January 2019 Published: 29 January 2019

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Abstract

Spinal epidermoids are rare tumors comprising less than 1% of all intraspinal tumors. These tumors are usually found as intramedullary space occupying lesions (SOLs) in cervico-dorsal and as intradural SOLs in lumbo-sacral region. Thier origin has been advocated to be congenital or acquired. These tumors have been reported in patients of age group 03 yrs to 55 yrs in various case reports/small series in literature. The usual presentation is that of slowly progressive spastic paraparesis / quadriparesis with or without sphincter involvement as in IMSOLs / IDEMs lesions of the spinal cord. These tumors pose a diagnostic dillema due to there rarity. The diagnosis of these tumors may be delayed as they have similar symptoms and signs as in any other intradural spinal patholgy. The preoperative diagnosis can be made with reasonable certainity dedicated MRI sequences (diffusion weighted & ADC) are carried out. Since these tumors are benign, an early diagnosis gives the patient a realtively good prognosis. We report two such unusual cases which came as diagnostic surprise on operative table and that too within a period of 06 months. Microscopic total excision relatively early in the course of the illness in both these patients had satisfactory outcome with good neurological recovery and no recurrence over last 24 months.

Published in	Clinical Neurology and Neuroscience (Volume 2, Issue 3)
DOI	10.11648/j.cnn.20180203.12
Page(s)	56-60
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Epidermoid Cyst, Intradural, IDEM, Spinal, Diffusion Weighted Images (DWI)

References

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[2]	Gonzalvo A, Hall N, McMahon JH, Fabinyi GC. Intramedullary spinal epidermoid cyst of the upper thoracic region. J Clin Neurosci; 200916 (1):142-4.
[3]	Cataltepe O, Berker M, Akalan N. A giant intramedullary spinal epidermoid cyst of the cervicothoracic region. Pediatr Neurosurg 2004; 40 (3):120-3.
[4]	Ferrara P, Costa S, Rigante D et al. Intramedullary epidermoid cyst presenting with abnormal urological manifestations. Spinal Cord 2003; 41 (11):645-8.
[5]	Teksam M, Casey So, Michel E, Benson M, Truwit CL. Intraspinal epidermoid cyst.: diffusion – weighted MRI. Neuroradiology 2001; 43 (7)572-4.
[6]	Maiuri F, Gangemi M, Cavallo LM, De Divitiis E. Dysembryogenetic spinal tumours in adults without dysraphism. Br J Neurosurg 2003; 17:234-8.
[7]	Jeong IH, Lee JK, Moon KS, Kwak HJ, Joo SP, Kim TS. Iatrogenic intraspinal epidermoid tumour: Case report. Paediatric Neurosurgery 2006; 42:395-8.
[8]	Penisson IB, Gilles G, Gandon Y: Intramedullary epidermoid cyst evaluated by computed tomographic scan and MRI. Case report. Neurosurgery 1989; 25: 955-959.
[9]	Guidetti B, Gagliardi FM: Epidernoid and dermoid cysts clinical evaluation and late surgical results. L Neurosurg 1997; 47: 12-18.
[10]	Manno NJ, Uihiein A, Kernohan JW: Intraspinal epidermoids. J Neurosurg 1962; 19: 754-765.
[11]	Chandra PS, Manjari T, Devi PI, Chandramouli BA, Srikanth SG, Shankar SK. Intramedullary spinal epidermoid cyst. Neurol India 2000; 48; 75-7.
[12]	Lee JH et al. Intramedullary epidermoid cyst in thoracolumbar region: A case report. Kor J Spine 2008; 5 (3): 219-224.
[13]	Sun J, Zhang Q, Bao X. Diagnosis and surgical treatment of intradural epidermoid cyst of the spinal cord. Zhonghua Wai Ke Za Zhi 1998; 36:52-3.
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[19]	Vivek B. Beechar, Pascal O. Zinn, Kent A. Heck, Gregory N. Fuller, Inbo Han, Akash J. Patel, Alexander E. Ropper. Spinal Epidermoid Tumors: Case Report and Review of the Literature. Neurospine. 2018 Jun; 15 (2): 117–122.

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APA Style

Sanjay Kumar, Krishan Kumar Yadav, Saurabh Kumar Verma. (2019). Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clinical Neurology and Neuroscience, 2(3), 56-60. https://doi.org/10.11648/j.cnn.20180203.12

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ACS Style

Sanjay Kumar; Krishan Kumar Yadav; Saurabh Kumar Verma. Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clin. Neurol. Neurosci. 2019, 2(3), 56-60. doi: 10.11648/j.cnn.20180203.12

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AMA Style

Sanjay Kumar, Krishan Kumar Yadav, Saurabh Kumar Verma. Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clin Neurol Neurosci. 2019;2(3):56-60. doi: 10.11648/j.cnn.20180203.12

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@article{10.11648/j.cnn.20180203.12,
  author = {Sanjay Kumar and Krishan Kumar Yadav and Saurabh Kumar Verma},
  title = {Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma},
  journal = {Clinical Neurology and Neuroscience},
  volume = {2},
  number = {3},
  pages = {56-60},
  doi = {10.11648/j.cnn.20180203.12},
  url = {https://doi.org/10.11648/j.cnn.20180203.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20180203.12},
  abstract = {Spinal epidermoids are rare tumors comprising less than 1% of all intraspinal tumors. These tumors are usually found as intramedullary space occupying lesions (SOLs) in cervico-dorsal and as intradural SOLs in lumbo-sacral region. Thier origin has been advocated to be congenital or acquired. These tumors have been reported in patients of age group 03 yrs to 55 yrs in various case reports/small series in literature. The usual presentation is that of slowly progressive spastic paraparesis / quadriparesis with or without sphincter involvement as in IMSOLs / IDEMs lesions of the spinal cord. These tumors pose a diagnostic dillema due to there rarity. The diagnosis of these tumors may be delayed as they have similar symptoms and signs as in any other intradural spinal patholgy. The preoperative diagnosis can be made with reasonable certainity dedicated MRI sequences (diffusion weighted & ADC) are carried out. Since these tumors are benign, an early diagnosis gives the patient a realtively good prognosis. We report two such unusual cases which came as diagnostic surprise on operative table and that too within a period of 06 months. Microscopic total excision relatively early in the course of the illness in both these patients had satisfactory outcome with good neurological recovery and no recurrence over last 24 months.},
 year = {2019}
}

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TY - JOUR
T1 - Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma
AU - Sanjay Kumar
AU - Krishan Kumar Yadav
AU - Saurabh Kumar Verma
Y1 - 2019/01/29
PY - 2019
N1 - https://doi.org/10.11648/j.cnn.20180203.12
DO - 10.11648/j.cnn.20180203.12
T2 - Clinical Neurology and Neuroscience
JF - Clinical Neurology and Neuroscience
JO - Clinical Neurology and Neuroscience
SP - 56
EP - 60
PB - Science Publishing Group
SN - 2578-8930
UR - https://doi.org/10.11648/j.cnn.20180203.12
AB - Spinal epidermoids are rare tumors comprising less than 1% of all intraspinal tumors. These tumors are usually found as intramedullary space occupying lesions (SOLs) in cervico-dorsal and as intradural SOLs in lumbo-sacral region. Thier origin has been advocated to be congenital or acquired. These tumors have been reported in patients of age group 03 yrs to 55 yrs in various case reports/small series in literature. The usual presentation is that of slowly progressive spastic paraparesis / quadriparesis with or without sphincter involvement as in IMSOLs / IDEMs lesions of the spinal cord. These tumors pose a diagnostic dillema due to there rarity. The diagnosis of these tumors may be delayed as they have similar symptoms and signs as in any other intradural spinal patholgy. The preoperative diagnosis can be made with reasonable certainity dedicated MRI sequences (diffusion weighted & ADC) are carried out. Since these tumors are benign, an early diagnosis gives the patient a realtively good prognosis. We report two such unusual cases which came as diagnostic surprise on operative table and that too within a period of 06 months. Microscopic total excision relatively early in the course of the illness in both these patients had satisfactory outcome with good neurological recovery and no recurrence over last 24 months.
VL - 2
IS - 3
ER -

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Author Information

Sanjay Kumar

Department of Neurosurgery, Command Hospital (Central Command), Lucknow, India
Krishan Kumar Yadav

Department of Neurosurgery, Command Hospital (Air Force), Bengluru, India
Saurabh Kumar Verma

Department of Neurosurgery, Army Hospital (Research & Referral), New Delhi, India

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APA Style

Sanjay Kumar, Krishan Kumar Yadav, Saurabh Kumar Verma. (2019). Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clinical Neurology and Neuroscience, 2(3), 56-60. https://doi.org/10.11648/j.cnn.20180203.12

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ACS Style

Sanjay Kumar; Krishan Kumar Yadav; Saurabh Kumar Verma. Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clin. Neurol. Neurosci. 2019, 2(3), 56-60. doi: 10.11648/j.cnn.20180203.12

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AMA Style

Sanjay Kumar, Krishan Kumar Yadav, Saurabh Kumar Verma. Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma. Clin Neurol Neurosci. 2019;2(3):56-60. doi: 10.11648/j.cnn.20180203.12

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@article{10.11648/j.cnn.20180203.12,
  author = {Sanjay Kumar and Krishan Kumar Yadav and Saurabh Kumar Verma},
  title = {Spinal Epidermoids - Rare Tumours Posing a Diagnostic Dilemma},
  journal = {Clinical Neurology and Neuroscience},
  volume = {2},
  number = {3},
  pages = {56-60},
  doi = {10.11648/j.cnn.20180203.12},
  url = {https://doi.org/10.11648/j.cnn.20180203.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20180203.12},
  abstract = {Spinal epidermoids are rare tumors comprising less than 1% of all intraspinal tumors. These tumors are usually found as intramedullary space occupying lesions (SOLs) in cervico-dorsal and as intradural SOLs in lumbo-sacral region. Thier origin has been advocated to be congenital or acquired. These tumors have been reported in patients of age group 03 yrs to 55 yrs in various case reports/small series in literature. The usual presentation is that of slowly progressive spastic paraparesis / quadriparesis with or without sphincter involvement as in IMSOLs / IDEMs lesions of the spinal cord. These tumors pose a diagnostic dillema due to there rarity. The diagnosis of these tumors may be delayed as they have similar symptoms and signs as in any other intradural spinal patholgy. The preoperative diagnosis can be made with reasonable certainity dedicated MRI sequences (diffusion weighted & ADC) are carried out. Since these tumors are benign, an early diagnosis gives the patient a realtively good prognosis. We report two such unusual cases which came as diagnostic surprise on operative table and that too within a period of 06 months. Microscopic total excision relatively early in the course of the illness in both these patients had satisfactory outcome with good neurological recovery and no recurrence over last 24 months.},
 year = {2019}
}

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