Miller Mark, Chahlavi Ali
Lake Erie College of Osteopathic Medicine, Bradenton FL, USA.
Ascension Health St Vincent Hospital, Department of Neurosurgery, Jacksonville FL, USA.
N Am Spine Soc J. 2022 May 17;10:100124. doi: 10.1016/j.xnsj.2022.100124. eCollection 2022 Jun.
Intramedullary dermoid cysts within the spine are a rare benign tumor. We present this case, which has atypical presenting symptoms, in order to increase awareness of intradural dermoid cysts.
We present here a case of a 42 year old man with a 12-month history of lumbar spinal pain as well progressive left lower extremity loss of strength, as well as numbness and paresthesia radiating into the left foot. Magnetic resonance imaging scan revealed a 4 × 1 × 1.3cm intradural mass at the cauda equina L1-L2 region and was hyperintense in both T1 and T2 causing cord compression. L1-L2 laminectomy and intradural micro resection were performed with successful excision of the suspicious mass. Histopathological review revealed keratinaceous debris and adnexal structures consistent with a dermoid cyst.
Our case is unusual with the other reported cases of dermoid cysts due to superior involvement in the lumbar region compared to other case reports with predominantly lumbosacral involvement. This location of the cyst lead to radicular symptoms, rather than lumbosacral pain and sphincter incompetence that is more commonly represented in the literature.
脊柱内髓内皮样囊肿是一种罕见的良性肿瘤。我们呈现此例具有非典型症状的病例，以提高对硬脊膜内皮样囊肿的认识。
我们在此报告一例42岁男性，有12个月的腰椎疼痛病史，同时伴有左下肢进行性肌力丧失，以及向左足放射的麻木和感觉异常。磁共振成像扫描显示在L1 - L2马尾区域有一个4×1×1.3cm的硬脊膜内肿块，在T1和T2加权像上均为高信号，导致脊髓受压。行L1 - L2椎板切除术及硬脊膜内显微切除术，成功切除可疑肿块。组织病理学检查显示有角蛋白碎屑和附属结构，符合皮样囊肿表现。
与其他主要累及腰骶部的皮样囊肿病例报告相比，我们的病例不同寻常之处在于囊肿主要累及腰椎区域。囊肿的这个位置导致了神经根症状，而非文献中更常见的腰骶部疼痛和括约肌功能障碍。
