Epidermoid cyst - thoracic spine

Case contributed by A.Prof Frank Gaillard

Presentation

Mid-level spine pain.

Patient Data

Age: 45 years
Gender: Female

An intradural lesion is demonstrated at the level of T5 occupying the left posterolateral 2/3 of the cross-sectional area of the thecal sac. The spinal cord is distorted, displaced anterolaterally to the right, with no edema within the cord. The interface between the lesion and cord is indistinct at one level, raising the possibility of a combined intradural and partial intramedullary lesion-although note that the vast majority of the lesion is clearly extramedullary. There is no abnormal enhancement of the lesion, no evidence of lesional fat, and no abnormal enhancement of the dura.

Case Discussion

The patient went on to have surgery and the lesion resected.

Histology

The sections show a collapsed cyst. This is lined by squamous epithelium with a discernible granular layer and contains laminated keratin. No appendageal structures or mesenchymal elements are identified. There is no evidence of a tumor.

FINAL DIAGNOSIS: spinal epidermoid cyst.

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Case information

rID: 60628
Published: 2nd Jun 2018
Last edited: 11th Feb 2019
Inclusion in quiz mode: Included

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