A review on five cases of intramedullary dermoid cyst

Abstract

Purpose: Intramedullary dermoid cyst is a type of rare congenital intraspinal lesions. Its proximity and its strong adherence to the surrounding spinal cord tissue often make a complete resection of the cyst wall problematic. We retrospectively studied five cases of intramedullary dermoid cyst, focusing the recurrence of intramedullary dermoid cyst after surgery and the probable method to prevent the recurrence.

Methods: Five cases of intramedullary dermoid cyst with or without other concomitant deformities were retrospectively reviewed. Subjects consisted of three males and two females, aged 2–24 years. Diagnosis was confirmed by spinal MRI and pathology studies. Surgical outcomes were analyzed. In case 2, an Ommaya reservoir was implanted in the cystic cavity, and the cystic content was sucked though the Ommaya reservoir. An 18–113 months of follow-up was conducted.

Results: The contents of intramedullary dermoid cyst were loose and easy to be cleared in the operations. The cyst wall was closely adhered to the spinal cord, and complete resection was difficult. During the follow-up of 18–113 months, the lesion reoccurred in three cases.

Conclusion: Intramedullary dermoid cyst is prone to recurrence. The presence of residual cyst wall might be the cause of dermoid cyst recurrence. When a complete resection of cyst wall becomes infeasible, placement of an intraspinal Ommaya reservoir may help to delay and minimize clinical symptoms by aspiration of cystic contents in case of recurrence.