Case Report
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Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases

Year 2020, Volume: 73 Issue: 1, 89 - 92, 13.05.2020

Abstract

Intradural epidermoid tumors of the spinal cord are commonly associated with spinal cord dysraphism or invasive procedures. The spinal epidermoid tumor, frequently located intradural extramedullary region, is typically found in the lumbar region, and its placement in the thoracic region is rare. Furthermore, it is rarely observed without underlying spinal dysraphism or invasive intervention. The first case, a 52-year-old female patient was evaluated for back pain. On the thoracic magnetic resonance imaging (MRI) conducted, a 7-mm diameter intradural extramedullary non-enhancing nodular formation posterior to the T3 vertebra was detected. This lesion was completely excised via surgical intervention because of the increased size and the resultant hypoesthesia below T4 dermatome noted at follow-up. The second case, a 31-year-old woman presented with new-onset weakness in both legs. Notably, she has a history of a spinal mass lesion in the thoracic region 5 years ago. Thoracic MRI was performed to examine the recurrence, and it revealed a hypointense mass lesion axial plane with intradural extramedullary circumferential enhancement in the left posterior T6 level. This lesion was completely removed. No recurrence was noted at follow-up, and the histopathological diagnosis confirmed an epidermoid tumor.
An isolated epidermoid tumor should be considered in the differential diagnosis of intradural -extramedullary mass lesions of the thoracic region. The tumor was successfully resected in its entirety via surgical intervention without any neurological deficit. Our cases support the fact that surgical resection is a crucial factor in recurrence.

Ethical Statement

Informed consent was obtained from all the patients are including to the study

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References

  • 1. Barbagallo GMV, Maione M, Raudino G, et al. Thoracic Intradural- Extramedullary Epidermoid Tumor: The Relevance for Resection of Classic Subarachnoid Space Microsurgical Anatomy in Modern Spinal Surgery. Technical Note and Review of the Literature. World Neurosurg. 2017;108:54- 61.
  • 2. Bollar A, Prieto A, Allut AG, et al. Spinal epidermoid cysts without congenital anomalies associated. Report of two cases. J Neurosurg Sci. 1994;38:171- 175.
  • 3. Roux A, Mercier C, Larbrisseau A, et al. Intramedullary epidermoid cysts of the spinal cord. Case report. J Neurosurg. 1992;76:528-533.
  • 4. Lunardi P, Missori P, Gagliardi FM, et al. Long-term results of the surgical treatment of spinal dermoid and epidermoid tumors. Neurosurgery. 1989;25:860-864.
  • 5. Scarrow AM, Levy EI, Gerszten PC, et al. Epidermoid cyst of the thoracic spine: case history. Clin Neurol Neurosurg. 2001;103:220-222.
  • 6. Penisson-Besnier I, Guy G, Gandon Y. Intramedullary epidermoid cyst evaluated by computed tomographic scan and magnetic resonance imaging: case report. Neurosurgery. 1989;25:955-959.
  • 7. Maeda T, Mishima K, Imanishi J, et al. An Epidermoid Cyst of the Thoracic Spine in an Elderly Patient. World Neurosurg. 2019;127:113-116.
  • 8. Kukreja K, Manzano G, Ragheb J, Medina LS. Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusionweighted MRI useful? Pediatr Radiol. 2007;37:556-560.
  • 9. Per H, Kumandaş S, Gümüş H, et al. Iatrogenic epidermoid tumor: late complication of lumbar puncture. J Child Neurol. 2007;22:332-336.
  • 10. Gupta S, Gupta RK, Gujral RB, et al. Signal intensity patterns in intraspinal dermoids and epidermoids on MR imaging. Clin Radiol. 1993;48:405-413.

Torakal İntradural Ekstramedüller Epidermoid Tümör: Nadir İki Olgu

Year 2020, Volume: 73 Issue: 1, 89 - 92, 13.05.2020

Abstract

Project Number

-

References

  • 1. Barbagallo GMV, Maione M, Raudino G, et al. Thoracic Intradural- Extramedullary Epidermoid Tumor: The Relevance for Resection of Classic Subarachnoid Space Microsurgical Anatomy in Modern Spinal Surgery. Technical Note and Review of the Literature. World Neurosurg. 2017;108:54- 61.
  • 2. Bollar A, Prieto A, Allut AG, et al. Spinal epidermoid cysts without congenital anomalies associated. Report of two cases. J Neurosurg Sci. 1994;38:171- 175.
  • 3. Roux A, Mercier C, Larbrisseau A, et al. Intramedullary epidermoid cysts of the spinal cord. Case report. J Neurosurg. 1992;76:528-533.
  • 4. Lunardi P, Missori P, Gagliardi FM, et al. Long-term results of the surgical treatment of spinal dermoid and epidermoid tumors. Neurosurgery. 1989;25:860-864.
  • 5. Scarrow AM, Levy EI, Gerszten PC, et al. Epidermoid cyst of the thoracic spine: case history. Clin Neurol Neurosurg. 2001;103:220-222.
  • 6. Penisson-Besnier I, Guy G, Gandon Y. Intramedullary epidermoid cyst evaluated by computed tomographic scan and magnetic resonance imaging: case report. Neurosurgery. 1989;25:955-959.
  • 7. Maeda T, Mishima K, Imanishi J, et al. An Epidermoid Cyst of the Thoracic Spine in an Elderly Patient. World Neurosurg. 2019;127:113-116.
  • 8. Kukreja K, Manzano G, Ragheb J, Medina LS. Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusionweighted MRI useful? Pediatr Radiol. 2007;37:556-560.
  • 9. Per H, Kumandaş S, Gümüş H, et al. Iatrogenic epidermoid tumor: late complication of lumbar puncture. J Child Neurol. 2007;22:332-336.
  • 10. Gupta S, Gupta RK, Gujral RB, et al. Signal intensity patterns in intraspinal dermoids and epidermoids on MR imaging. Clin Radiol. 1993;48:405-413.
There are 10 citations in total.

Details

Primary Language English
Subjects Brain and Nerve Surgery (Neurosurgery)
Journal Section Case Report
Authors

Serdar Solmaz 0000-0001-7889-3396

Ümit Eroglu This is me 0000-0001-8623-071X

Onur Özgüral This is me 0000-0003-0592-6139

İhsan Doğan This is me 0000-0002-1985-719X

Orkhan Mammadkhanlı This is me 0000-0003-3299-4196

Ayhan Attar This is me 0000-0002-6525-1893

Project Number -
Publication Date May 13, 2020
Published in Issue Year 2020 Volume: 73 Issue: 1

Cite

APA Solmaz, S., Eroglu, Ü., Özgüral, O., Doğan, İ., Mammadkhanlı, O., & Attar, A. (2020). Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73(1), 89-92. https://doi.org/10.4274/atfm.galenos.2020.70783
AMA 1.Solmaz S, Eroglu Ü, Özgüral O, Doğan İ, Mammadkhanlı O, Attar A. Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020;73(1):89-92. doi:10.4274/atfm.galenos.2020.70783
Chicago Solmaz, Serdar, Ümit Eroglu, Onur Özgüral, İhsan Doğan, Orkhan Mammadkhanlı, and Ayhan Attar. 2020. “Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73 (1): 89-92. https://doi.org/10.4274/atfm.galenos.2020.70783.
EndNote Solmaz S, Eroglu Ü, Özgüral O, Doğan İ, Mammadkhanlı O, Attar A (May 1, 2020) Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73 1 89–92.
IEEE [1]S. Solmaz, Ü. Eroglu, O. Özgüral, İ. Doğan, O. Mammadkhanlı, and A. Attar, “Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 73, no. 1, pp. 89–92, May 2020, doi: 10.4274/atfm.galenos.2020.70783.
ISNAD Solmaz, Serdar - Eroglu, Ümit - Özgüral, Onur - Doğan, İhsan - Mammadkhanlı, Orkhan - Attar, Ayhan. “Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73/1 (May 1, 2020): 89-92. https://doi.org/10.4274/atfm.galenos.2020.70783.
JAMA 1.Solmaz S, Eroglu Ü, Özgüral O, Doğan İ, Mammadkhanlı O, Attar A. Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020;73:89–92.
MLA Solmaz, Serdar, et al. “Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 73, no. 1, May 2020, pp. 89-92, doi:10.4274/atfm.galenos.2020.70783.
Vancouver 1.Solmaz S, Eroglu Ü, Özgüral O, Doğan İ, Mammadkhanlı O, Attar A. Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases. Ankara Üniversitesi Tıp Fakültesi Mecmuası [Internet]. 2020 May 1;73(1):89-92. Available from: https://izlik.org/JA65TD36EC