Intradural Epidermoid Cyst: A Case Report

Shin, Byung Joon; Park, Jun Young; Yun, Tae Kyung; Kim, Kyung Je; Kim, Yon Il

Abstract

STUDY DESIGN: A case report and review of the literature.
OBJECTIVES
To discuss the iatrogenic intradural-extramedullary epidermoid cyst and review the literatures. SUMMARY OF LITERATURE REVIEW: Intradural epidermoid cyst has two types of lesions, congenital and iatrogenic. The former is fre-quently associated with bone or skin malformations(spina bifida. etc) and the latter resulting from lumbar puncture, due to direct implantation of epithelial cell by puncture needle.
MATERIALS AND METHODS
A 13-year-old boy had pain radiating down to the right lower extremity and hypoesthesia on the anterolateral aspect of right thigh. Straight leg raising was markedly limited. T1 weighted image reveals round intradural mass on L3-4, which was not enhanced by gadolinium. He had the history of spinal tapping two and a half years ago for the work-up of headache.
RESULTS
The mass was excised through posterior approach and midline durotomy. It was whitish ovoid mass, measuring 2x1.5x1.5cm in size and histologically diagnosed as epidermoid cyst consisting of keratinous material and cholesterol. All the symptoms were completely relieved at 16 months follow-up.
CONCLUSIONS
A case of iatrogenic epidermoid cyst was successfully treated by excision. Epidermoid cyst must be ruled out if space occupying lesion exists in lumbar spine and patients complaining of lower back pain.