Presentation
Pain in the lower back and sacral region since 3-4 years. No history of bowel/ bladder involvement with normal developmental milestones. Normal physical examination. No evidence of sinus tract or external cutaneous opening overlying the sacral region.
Patient Data
MRI shows the presence of a well-defined intradural extramedullary cystic lesion in the lumbar region of the spinal canal. The lesion is hyperintense on T2 weighted and STIR sequences, hypointense on T1 weighted images, and shows post-contrast enhancement of the wall. The hyperintense signal is suppressed on FLAIR and the lesion shows restricted diffusion. Features are suggestive of an epidermoid cyst in the lumbar spinal canal.
The lesion compresses the cauda equina and conus medullaris towards the left side without any evidence of abnormal signal intensity in the conus medullaris.
Also, noted is made of Tarlov cysts at S2-3 levels and fatty infiltration of filum terminale.
Case Discussion
Spinal epidermoid tumors are rare, comprising of less than 1% of tumors involving the spine and about 10% of intraspinal tumors in children 1,2. Spinal epidermoid tumors or cysts are typically intradural extramedullary & most commonly seen in the lumbar spine 3,4.
Unable to process the form. Check for errors and try again.