A thoracic intradural intramedullary epidermoid in a 12-years old female without any evidence of spinal dysraphism

Abstract

The spinal epidermoid lesion is an extremely rare benign condition, seen in < 1% of all spinal tumours and are most commonly associated with spinal dysraphism. They are more common in young children and have female preponderance. They can be either congenital or acquired with congenital being more common. They are most commonly located in the thoracic region. They grow slowly and present with back pain and progressive neurological deficit with or without bladder bowel involvement. We present a case of a 12-year-old female child with gradually progressive neurological deficit in the form of spastic paraparesis and decreased sensation with early bladder involvement. Her contrast MRI dorsolumbar spine showed a well defined intradural intramedullary lesion hypointense on T1 image, hyperintense on T2 image with no contrast enhancement at D10-D11 level. The patient was managed by surgical intervention with D9-D10-D11 laminectomy with total excision of the mass. Postoperatively on follow up patient had gradually improved motor and sensory symptoms with no improvement in bladder symptoms. Her histopathological study was confirmative of an epidermoid cyst.