A Neglected case admitted with paraplegia: An intradural extramedullary epidermoid cyst

Year 2012, , 270 - 272, 01.06.2012

Nihal Özaras Mustafa Akif Sarıyıldız Saliha Eroğlu Demir Feyza Karagöz Güzey Feyza Karagöz Güzey Abdurahman Aycan Meltem Esenyel

https://doi.org/10.5799/ahinjs.01.2012.02.0158

Cited By: 2

Abstract

Spinal epidermoid tümörler, spinal tümörlerin %1.5-2'sini oluşturan nadir tümörlerdir. Servikal ve torasik spinal kord epidermoid tümörleri oldukça nadirdir. Bu yazıda polikliniğimize üriner inkontinans ve paraparezi ile başvuran torasik bölgede intradural ekstramedüller epidermoid kist tespit edilen 28 yaşında bir olgu sunuldu. Hastanın ilk şikayetleri 16 yıl önce başlamış. Bu dönemde hastaya peroneal muskuler atrofi teşhisi konulmuş ve ayrıntılı tetkik edilememiş. Geç tanı ve tedavi nedeniyle başarılı cerrahi ve kapsamlı fizik tedaviye rağmen mevcut paraparezi ve üriner inkontinans düzelmedi. Spinal epidermoid tümörlerin prognozu histolojik olarak benign oldukları için iyidir. Erken teşhis edilirse tam cerrahi rezeksiyon hastaya iyi nörolojik sonuç sağlar. Nörolojik defisiti mevcut olan hastaların kapsamlı araştırılması ve en erken sürede teşhis konulması hayati önem taşımaktadır.

Keywords

Epidermal kist, omirilik sıkışması, omirilik neoplazileri, parapleji, erken tanı

A Neglected case admitted with paraplegia: An intradural extramedullary epidermoid cyst

Abstract

Spinal epidermoid tumors are rare tumors, constituting about 1.5-2% of the spinal tumors. Cervical and thoracic spinal cord epidermoid tumors are exceedingly rare. We reported a case of a 28-year-old patient with an intradural extramedullary epidermoid cyst at the thoracic region presented with urinary incontinence and paraparesis to our outpatient clinic. First symptoms of patient started 16 years ago and diagnosed as peroneal muscular atrophy and he couldn\'t be investigated sufficiently. Because of the delayed diagnosis and treatment, paraparesis and urinary incontinence were persistent in spite of successful surgery and proper physical therapy. Spinal epidermoid tumors have a good prognosis, as they are histologically benign. When diagnosed early, complete surgical resection offers the patient good neurologic outcome. It is important to investigate extensively patients with neurological deficits and to make diagnosis as soon as possible. J Clin Exp Invest 2012; 3(2): 270-272

Keywords

Epidermal cyst, spinal cord compression, spinal cord neoplasms, paraplegia, early diagnosis

References

• Scarrow AM, Levy EI, Gerszten PC, Kulich SM, Chu CT, Welch WC. Epidermoid cyst of the thoracic spine: case history. Clin Neurol Neurosurg 2001;103(4):220- 2.
• Gonzalvo A, Hall N, McMahon JH, Fabinyi GC. Intra- medullary spinal epidermoid cyst of the upper thoracic region. J Clin Neurosci 2009;16(1):142-4.
• Cataltepe O, Berker M, Akalan N. A giant intramedul- lary spinal epidermoid cyst of the cervicothoracic re- gion. Pediatr Neurosurg 2004;40(3):120-3.
• Ferrara P, Costa S, Rigante D, et al. Intramedullary epidermoid cyst presenting with abnormal urological manifestations. Spinal Cord 2003;41(11):645-8.
• Teksam M, Casey SO, Michel E, Benson M, Truwit CL. Intraspinal epidermoid cyst: diffusion-weighted MRI. Neuroradiology 2001;43(7):572-4.
• Osenbach RK, Godersky JC, Traynelis VC, Schelper RD. Intradural extramedullary cysts of the spinal ca- nal: clinical presentation, radiographic diagnosis, and surgical management. Neurosurgery 1992;30(1):35- 42.
• Jellema K, Overbeeke JJ, Teepen HL, Visser LH. Time to diagnosis of intraspinal tumors. Eur J Neurol 2005;12(8):621-4.
• Reina M, Lopez-Garcia A, Dittmann M, de Andres J, Blazquez M. Iatrogenic spinal epidermoid tumors. A late complication of spinal puncture. Rev Esp Aneste- siol Reanim 1996;43(4):142-6.