Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 17, 2016
Acquired Epidermoid Cyst
- Background:
- Epidermoid cyst or epidermoid tumor is usually an extramedullary intraspinal mass that arises from cells embryologically derived from epidermal (skin) elements. It can be congenital or acquired (after lumbar puncture or surgery).
- Clinical Presentation:
- In this case, the symptomatology was compression of the cauda equina, but it can be asymptomatic or present as infectious or chemical meningitis.
- Key Diagnostic Features:
- The best imaging technique to evaluate an epidermoid cyst is MRI. The characteristics findings are an iso/hypointense intradural extramedullary mass on T1WI that is hyperintense in T2WI. There is usually no contrast enhancement, and the lesion demonstrates restricted diffusion.
- Differential Diagnosis:
- Arachnoid cyst
- Neurenteric cyst
- Treatment:
- Surgical excision is the standard treatment, but radiotherapy can be an alternative in patients who cannot undergo surgery.
