Lumbar dermoid cyst causing aseptic meningitis

Öz

Abstract. Dermoid cysts are rarely occurring intramedullary spinal cord tumors and they develop due to the inclusion of epithelial elements during closure of the neural tube. They may be detected in the medulla spinalis region extending from cervicomedullary junction to conus medullaris. Spontaneous and iatrogenic rupture of the dermoids causes recurrent meningitis by discharging their contents into subarachnoid space. The purpose of this report is to consider spinal dermoid cysts in the differential diagnosis of young patients with the findings of aseptic meningitis to avoid misdiagnosis and inadequate treatment.

Key words: Abscess, dermoid cyst, meningeal irritation

Anahtar Kelimeler

• Abscess, dermoid cyst, meningeal irritation

Kaynakça

1. Messori A, Polonara G, Serio A, Gambelli E, Salvolini U. Expanding experience with spontaneous dermoid rupture in the MRI era: diagnosis and follow-up. Eur J Radiol 2002; 43: 19- 27.
2. Ziv ET, Gordon McComb J, Krieger MD, Skaggs DL. Iatrogenic intraspinal epidermoid tumor: two cases and a review of the literature. Spine 2004; 29: 15-18.
3. Gao B, Yang J, Zhuang S, et al. Mollaret meningitis associated with an intraspinal epidermoid cyst. Pediatrics 2007; 120: 220-224.
4. Bruyn GW, Straathof LJ, Raymakers GM. Mollaret’s meningitis: differential diagnosis and diagnostic pitfalls. Neurology 1962; 12: 745-753.
5. Vilaseca J, Tor J, Guardia J, Bacardi R. Periodic meningitis and familial Mediaterranean fever. Arch Intern Med 1982; 142: 378-379.
6. Schwartz JF, Balentine JD. Recurrent meningitis due to an intracranial epidermoid. Neurology 1978; 28: 124-129.
7. Agnoli AL, Laun A, Schönmayr R. Enterogenous intraspinal cysts. J Neurosurg 1984; 61: 834-840.
8. Steinbok P, Cochrane DD, Poskitt K. Intramedullary spinal Neurosurg Clin N Am 1992; 3: 931-945. in children.

9. Barth A, Pizzolato GP, Berney J. Melanocytome meinge intramedulaire. Neurochirurgie 1993; 39: 188-194.
10. Mark Mumenthaler, Otto Appenzeller (eds). Neurologic differential diagnosis, New York, Georg Thieme Verlag 1992: 156-159.
11. Graham DV, Tampieri D, Villemure JG. Intramedullary dermoid tumor diagnosed with the assistance of magnetic resonance imaging. Neurosurgery 1988; 23: 765-767.
12. Gregorios JB, Gree B, Page L. Spinal cord tumors presenting with neural tube defects. Neurosurgery 1986; 19: 962-966.
13. Stein BM. Surgery of intramedullary spinal cord tumors. Clin Neurosurg 1979; 26: 529-542.
14. Froment A, Celi P, Palma L. Oligodendrogliomas of the spinal cord. Acta Neurochir 1980; 52: 305-329.
15. David G. Mclone. Anomalies of the spine and spinal cord. In Bermans J Iskandar and W Jerry Oakes, eds. Chicago. Pediatric Neurosurgery 2001; 307- 317.
16. Aristegui FJ, Delgado RA, Oleaga ZL, Hermosa CC. Mollaret’s recurrent aseptic meningitis and cerebral epidermoid cyst. Pediatr Neurol 1998; 18: 156-159.
17. Helvaci M, Kasirga E, Cetin N, Yaprak I. Intramedullary spinal cord abcess suspected of Brucella infection. Pediatrics International 2002; 44: 446-448.
18. Rotbart HA. Viral meningitis. Semin Neurol 2000; 20: 277-292.
19. Peter C. Burger, Bernd W Scheithauer. Benign Cystic Lesions; Tumors of the Central Nervous System. Washington 1994; 362-365.
20. Froment A, Celi P, Palma L.
21. Oligodendrogliomas of the spinal cord. Acta Neurochir 1980; 52: 305-329.