Ferrara P, Costa S, Rigante D, Mule A, D'Aleo C, Pulitanò S, Belli P, Menchinelli P, Caldarelli M
Department of Paediatrics, Catholic University--A Gemelli Hospital, Rome, Italy.
Spinal Cord. 2003 Nov;41(11):645-8. doi: 10.1038/sj.sc.3101482.
Report of an epidermoid cyst with intramedullary localization.
To describe an atypical presentation of intramedullary epidermoid cyst.
Intramedullary epidermoid cysts are rare entities with a marked variability in the clinical presentation, essentially of neurological pertinence.
Case report of a spinal epidermoid cyst in a 13-year-old girl presenting with urological symptoms: she had a 12-month history of recurrent low urinary tract infections, urinary frequency and nocturnal enuresis. A urodynamic evaluation was performed and showed the presence of involuntary bladder contractions with detrusor instability and low bladder compliance. Magnetic resonance imaging of the spine demonstrated an intramedullary lesion of the dorsal spinal cord.
The mass was excised and 6 months after surgical excision, urological manifestations improved with decreased detrusor hyper-reflexia, increased bladder capacity and compliance and no later report of urinary tract infections.
In our patient, unusual clinical manifestations of the tumor have delayed the diagnosis, but its complete removal has led to remission of symptoms. Detailed neurological examination and investigations are indicated in patients with clinical and urodynamic features, suggestive of neuropathic bladder.
髓内定位表皮样囊肿的报告。
描述髓内表皮样囊肿的非典型表现。
髓内表皮样囊肿罕见，临床表现差异显著，主要与神经相关。
一名13岁女孩脊柱表皮样囊肿的病例报告，该女孩出现泌尿系统症状：有12个月复发性下尿路感染、尿频和夜间遗尿病史。进行了尿动力学评估，显示存在逼尿肌不稳定和膀胱顺应性低的非自主性膀胱收缩。脊柱磁共振成像显示脊髓背侧有髓内病变。
肿物被切除，手术切除6个月后，泌尿系统表现改善，逼尿肌反射亢进减轻，膀胱容量和顺应性增加，且无后续尿路感染报告。
在我们的患者中，肿瘤不寻常的临床表现延迟了诊断，但完整切除导致症状缓解。对于具有临床和尿动力学特征提示神经源性膀胱的患者，应进行详细的神经学检查和调查。
