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.
Case Discussion
Spinal epidermoid tumours are rare, comprising of less than 1% of tumours involving the spine and about 10% of intraspinal tumours in children 1,2. Spinal epidermoid tumours or cysts are typically intradural extramedullary & most commonly seen in the lumbar spine 3,4.