Intramedullary Spinal Epidermoid Cyst-A Rare Cause of Spastic Paraparesis

Abstract

Spinal intramedullary epidermoids are rare intramedullary lesions of the spinal cord. They may be congenital or acquired with the congenital type often associated with spinal dysraphism and other spinal anomalies. The clinical presentation depends on the level of the involvement of the spinal cord. Management of these lesions is surgical excision. We report a case of intramedullary spinal epidermoid who presented with spastic paraparesis.

Keywords: epidermoid cyst; intramedullary epidermoid; intramedullary tumors; spastic paraparesis; spinal tumor.

Fig. 1

( A ) Sagittal T2-weighted image showing a heterogeneous, partly hypointense lesion in dorsal spinal cord posteriorly at D4 level. ( B ) Precontrast fat-saturated T1-weighted image showing heterogeneous, partly hyperintense D4 cord lesion. ( C ) Postcontrast fat-saturated T1-weighted image showing patchy contrast enhancement of D4 cord lesion. ( D ) Postcontrast T1-weighted axial image showing enhancing lesion at the posterior aspect of the cord at D4 level. ( E ) Sagittal gradient recalled echo image showing blooming in the lesion. ( F ) Photomicrograph depicting the cyst contents composed with areas of dystrophic calcification (red arrow) and cholesterol clefts (black arrow) (hematoxylin and eosin, x100).