Carré S, Sanoussi S, Dietemann J L, Salatino S, Guessoum M
Service de Radiologie, Hôpitaux universitaires, hôpital de Hautepierre, Strasbourg.
J Neuroradiol. 1997 Jun;24(1):65-7.
Epidermoid cysts are rare intradural extramedullary tumors. There are two types of lesions: congenital spinal cysts frequently associated with other bone or skin malformations (spina bifida aperta, dermal sinus ...) and iatrogenic spinal cysts resulting from lumbar puncture. In both situations, clinical and the radiologic findings are similar. We describe an epidermoid cyst in a 52-year-old female affected with a lumbar pain and recent urinary disorders. Symptoms were slow to appear and dependent on the location of the cyst. Epidermoid cyst contained keratin, cholesterol crystals and desquamed epithelial cells. On CT, epidermoid cyst was a hypodense lesion on MR. On T1 weighted images the tumor was hypointense. The signal appeared heterogeneous. There was no enhancement after Gadolinium DTPA injection. Differential diagnosis included: ependymoma, hemangioblastoma, neurinoma, meningioma and metastasis, but all these lesions are enhanced by contrast injection.
表皮样囊肿是罕见的硬脊膜内髓外肿瘤。有两种类型的病变：先天性脊髓囊肿常与其他骨骼或皮肤畸形相关（开放性脊柱裂、皮样窦道……）以及因腰椎穿刺导致的医源性脊髓囊肿。在这两种情况下，临床和影像学表现相似。我们描述了一名52岁女性的表皮样囊肿，该患者患有腰痛和近期出现的泌尿系统疾病。症状出现缓慢且取决于囊肿的位置。表皮样囊肿含有角蛋白、胆固醇结晶和鳞状上皮细胞。在CT上，表皮样囊肿是低密度病变；在磁共振成像（MR）上，在T1加权图像上肿瘤呈低信号。信号表现为不均匀。注射钆喷酸葡胺（Gadolinium DTPA）后无强化。鉴别诊断包括：室管膜瘤、血管母细胞瘤、神经鞘瘤、脑膜瘤和转移瘤，但所有这些病变在注射造影剂后都会强化。
