Devathasan Dillon, Murakami Masahiro, Miller Margaret A, Thomovsky Stephanie A, Lewis Melissa J
Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, United States.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States.
Front Vet Sci. 2022 Apr 15;9:871023. doi: 10.3389/fvets.2022.871023. eCollection 2022.
Congenital epidermoid cysts are slow-growing, mass lesions caused by the abnormal inclusion of neuroectodermal tissue within the developing central nervous system. Subtotal excision of epidermoid cysts increases the risk of early recurrence of clinical signs. A 4-year-old female spayed boxer was presented with a 4-month history of ambulatory paraparesis and proprioceptive ataxia. Neurological examination localized a T3-L3 myelopathy. MRI revealed a T1 iso- to hypointense, T2 and FLAIR hyperintense, rim-enhancing mass at the level of the T9-T10 vertebrae resulting in extradural compression of the spinal cord. This was histopathologically confirmed as an extradural epidermoid cyst following subtotal excision. MRI performed 2 months post-operatively revealed a significant decrease of the lesion volume. The dog was neurologically normal following the surgery however re-presented 28 months later with recurrence of clinical signs. A 28-month post-operative MRI revealed substantial enlargement of the epidermoid cyst. The dog was subsequently taken for repeat decompressive surgery. At 6 months from the repeat surgery, the dog was neurologically static with mild proprioceptive deficits. The case report highlights the clinical and MRI features of a recurrent extradural spinal epidermoid cyst treated by subtotal excision.
先天性表皮样囊肿是一种生长缓慢的肿块性病变，由发育中的中枢神经系统内神经外胚层组织异常包埋所致。表皮样囊肿次全切除会增加临床症状早期复发的风险。一只4岁已绝育的雌性拳师犬出现了4个月的行走性轻截瘫和本体感觉共济失调病史。神经学检查定位为T3-L3脊髓病。MRI显示在T9-T10椎体水平有一个T1等信号至低信号、T2和液体衰减反转恢复序列（FLAIR）高信号、边缘强化的肿块，导致脊髓硬膜外受压。次全切除后，组织病理学证实为硬膜外表皮样囊肿。术后2个月进行的MRI显示病变体积显著减小。手术后这只狗神经学检查正常，但28个月后因临床症状复发再次就诊。术后28个月的MRI显示表皮样囊肿明显增大。这只狗随后接受了再次减压手术。再次手术后6个月，这只狗神经学状态稳定，有轻度本体感觉缺陷。该病例报告突出了经次全切除治疗的复发性硬膜外脊髓表皮样囊肿的临床和MRI特征。
