Department of Critical Care Medicine, B & C Medical College Teaching Hospital & Research Center, Birtamode, Jhapa, Nepal.
JNMA J Nepal Med Assoc. 2020 Mar;58(223):192-194. doi: 10.31729/jnma.4268.
Intradural spinal epidermoid cysts are rare, benign lesions either acquired from trauma, surgery, lumbar puncture or arise as congenital lesions, particularly associated with spinal dysraphism. Epidermoid cyst arising from the spine with expansile destruction of vertebrae has not been reported yet in the literature. We report a case of 36-years male presented with history of fall 8 years back with progressive symptoms of lower back pain, weakness of left lower limb and bladder/bowel incontinence. Computed tomography revealed large lytic expansile, midline sacral vertebral lesion with soft tissue component and multiple calcific foci. Magnetic resonance imaging demonstrated large non-enhancing heterogeneous mass showing restricted diffusion on diffusion weighted images. The patient underwent biopsy confirming the diagnosis of an epidermoid cyst. The possibility of an epidermoid tumor should be kept in the differential diagnosis in patients presenting with post-traumatic sacral mass.
椎管内脊髓表皮样囊肿罕见，为良性病变，可由创伤、手术、腰椎穿刺获得，也可由先天性病变引起，特别是与脊柱发育不良有关。脊柱表皮样囊肿引起的椎体膨胀性破坏尚未见文献报道。我们报告一例 36 岁男性，8 年前有跌倒病史，逐渐出现下腰痛、左下肢无力和膀胱/肠道失禁症状。计算机断层扫描显示大的溶骨性膨胀性、中线上的骶骨椎体病变，伴有软组织成分和多个钙化灶。磁共振成像显示大的非增强不均匀肿块，弥散加权图像上显示弥散受限。患者行活检证实为表皮样囊肿。对于外伤性骶骨肿块患者，应在鉴别诊断中考虑表皮样肿瘤的可能性。
