Intramedullary dermoid cyst with relatively atypical symptoms: a case report and review of the literature

Maryam Sanaullah,Sanaullah Bashir,Sidra Mumtaz,Akhtar Amin Memon,Abdul Sattar Mohammad Hashim

doi:10.1186/1752-1947-7-104

Abstract

BackgroundIntraspinal dermoid cysts are rare and benign tumors that occur primarily due to the defective closure of the neural tube, an ectodermal derivative, during the process of development. They are slow-growing tumors manifesting in the second and third decades of life.Case presentationWe present here a case of a 14-year-old Sindhi boy with a six-month history of paraparesis of the lower limbs and a progressive loss of power of grade 3/5, and hypoesthesia in the L4/L5 dermatomes of his right lower limb. A plain magnetic resonance imaging scan revealed a well-demarcated intraspinal intramedullary cyst containing an abscess at the level of T12 and L1 causing localized cord compression, which was producing the symptoms. Near total excision of the cyst was successfully performed and was sent for biopsy, which revealed keratinocytes and keratin flakes. With one month of follow-up, along with physiotherapeutic management, the patient gradually improved and was able to walk without support.ConclusionsCritical evaluation of every case with aggravating symptoms should be carried out, and neurological and radiological examinations should be conducted to ensure the well-being of patients.

Highlights

Critical evaluation of every case with aggravating symptoms should be carried out, and neurological and radiological examinations should be conducted to ensure the well-being of patients
Amid the numerous defects and deviations from normal development patterns, very few exist as uncommon in medical history as the dermoid cyst
There is no exact knowledge of the prevalence of intracranial dermoid cysts, the few studies reported to date propose it to be 0.3 percent [1]

Summary

Conclusions

Our case is unusual in relation to the absence of the classic features of dermoid cysts and with the atypical symptoms of fecal retention. The patient presented to us six months after the initial complaint, with a misdiagnosis of spinal TB. Such a delay can progressively worsen the condition. These cases need appropriate diagnosis, which should entail the critical evaluation of every case, and for histopathology and radiological examinations to be conducted to ensure the well-being of the patients. Doi:10.1186/1752-1947-7-104 Cite this article as: Sanaullah et al.: Intramedullary dermoid cyst with relatively atypical symptoms: a case report and review of the literature. Author details 1Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan. Author details 1Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan. 2Department of Neurosurgery, Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan. 3Jinnah Postgraduate Medical Center, Rafique Shaheed Road, Karachi 35, Pakistan. 4Civil Hospital Karachi, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan

Introduction

Findings

Discussion