A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst
Introduction Intramedullary spinal epidermoid cysts have a reported incidence of less than 1% of intramedullary spinal cord tumors; and out of these, intramedullary epidermoid lesions within the cervical spinal cord are even rarer. Here, we present the case of an adult patient with an infected intr...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-03-01
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| Series: | Indian Journal of Neurosurgery |
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| author | Pawan Chawla Milind Sankhe |
| author_facet | Pawan Chawla Milind Sankhe |
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| description | Introduction Intramedullary spinal epidermoid cysts have a reported incidence of less than 1% of intramedullary spinal cord tumors; and out of these, intramedullary epidermoid lesions within the cervical spinal cord are even rarer. Here, we present the case of an adult patient with an infected intramedullary epidermoid cyst, identified on magnetic resonance imaging (MRI) at the C7–D1 level that was successfully excised without any worsening of neurological status.
Case Presentation A 23-year-old female patient presented with history of moderate degree intermittent fever followed by gradually progressive right-sided weakness. She had paresthesia below C5 dermatome on the right side. On close inspection of
the back, a tiny sinus opening was noted at the D2 level near the midline. MRI of the spine showed an intramedullary lesion at the C6–D1 level with the tract connecting to the subcutaneous lesion. Somatosensory evoked potential (SSEP) monitoring was done during the surgery with near total excision of the lesion.
Conclusion Even though the location is rare, a differential diagnosis of the epidermoid should always be considered. A tiny dermal sinus opening helped us in proper diagnosis, along with surgical excision, by providing us a direct path to the intramedullary lesion. An early diagnosis and treatment with neurophysiological monitoring helped us in the maximum safe resection of the lesion without developing any new deficit. |
| format | Article |
| id | doaj-art-ff6b50ee67f34e3d9bdcad4541104a46 |
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| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-ff6b50ee67f34e3d9bdcad4541104a462025-08-20T02:04:49ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672021-03-01100108008410.1055/s-0040-1708079A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid CystPawan Chawla0Milind Sankhe1Department of Neurosurgery, P. D. Hinduja National Hospital & Medical Research Centre, Mumbai, Maharashtra, IndiaDepartment of Neurosurgery, P. D. Hinduja National Hospital & Medical Research Centre, Mumbai, Maharashtra, IndiaIntroduction Intramedullary spinal epidermoid cysts have a reported incidence of less than 1% of intramedullary spinal cord tumors; and out of these, intramedullary epidermoid lesions within the cervical spinal cord are even rarer. Here, we present the case of an adult patient with an infected intramedullary epidermoid cyst, identified on magnetic resonance imaging (MRI) at the C7–D1 level that was successfully excised without any worsening of neurological status. Case Presentation A 23-year-old female patient presented with history of moderate degree intermittent fever followed by gradually progressive right-sided weakness. She had paresthesia below C5 dermatome on the right side. On close inspection of
the back, a tiny sinus opening was noted at the D2 level near the midline. MRI of the spine showed an intramedullary lesion at the C6–D1 level with the tract connecting to the subcutaneous lesion. Somatosensory evoked potential (SSEP) monitoring was done during the surgery with near total excision of the lesion. Conclusion Even though the location is rare, a differential diagnosis of the epidermoid should always be considered. A tiny dermal sinus opening helped us in proper diagnosis, along with surgical excision, by providing us a direct path to the intramedullary lesion. An early diagnosis and treatment with neurophysiological monitoring helped us in the maximum safe resection of the lesion without developing any new deficit.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1708079epidermoidintramedullarydermoid sinus |
| spellingShingle | Pawan Chawla Milind Sankhe A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst Indian Journal of Neurosurgery epidermoid intramedullary dermoid sinus |
| title | A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst |
| title_full | A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst |
| title_fullStr | A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst |
| title_full_unstemmed | A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst |
| title_short | A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst |
| title_sort | rare case of infected cervicodorsal intramedullary epidermoid cyst |
| topic | epidermoid intramedullary dermoid sinus |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1708079 |
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