Dorsal Intramedullary Epidermoid Cyst: Report of Two Rare Cases and Review of Literature

Abstract

Study Design A report on two rare cases of dorsal intramedullary spinal epidermoid cyst. Objective Clinical presentation, diagnosis, and surgical outcome of the two cases are discussed. Case Description We report two cases of dorsal intramedullary epidermoid cyst, both presenting with descending spastic upper motor neuron type of paraparesis with pain and paresthesia of the lower limbs and early involvement of bladder and bowel. Magnetic resonance imaging was done to come to a diagnosis where the first case was having a dorsal intramedullary epidermoid cyst at D6–D7 and the second case has an epidermoid cyst at D5–D6 intravertebral level. Results Near-total excision of the tumor was done in both the patients under microscope. Histopathologic examination confirmed the tumor as epidermoid. There was gradual neurologic improvement in both the cases on follow-up. Conclusion Cases presenting with dorsal myelopathy without spinal dysraphism may be due to rare causes such as epidermoid cyst, and near-total excision of such cyst with microneurosurgical technique can give a good outcome.