Coexistence of Subcutaneous Dermoid Cyst and Lipomyelomeningocele

  • Kim, Young-Hoon (Department of Neurosurgery, Seoul National University College of Medicine, Clinical Research Institute) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Seoul National University College of Medicine, Clinical Research Institute) ;
  • Chung, Chun-Kee (Department of Neurosurgery, Seoul National University College of Medicine, Clinical Research Institute)
  • Published : 2006.04.30

Abstract

Although lipomyelomeningocele and dermoid cyst are formed during a similar embryologic developmental stage of 'neural tube formation', they are caused by entirely different embryologic mechanisms. We encountered a case, which has not been previously reported, that had a lumbar subcutaneous dermoid cyst associated with lipomyelomeningocele. A 52-year-old man presented with a slowly growing lumbar mass of 3 years duration, which had been present since birth. Lumbosacral magnetic resonance imaging[MRI] showed lipomyelomeningocele at the L3, 4 and 5 levels and a subcutaneous cystic mass of high signal intensity on the T2 weighted image and iso or low signal intensity on the T1 weighted image. He underwent total resection of the lumbar subcutaneous mass. Intraoperative findings and histological examination were consistent with the preoperative diagnosis of a 'dermoid cyst'. We demonstrate that the formation of a dermoid cyst might coexist with lipomyelomeningocele during the embryologic developmental stage.

Keywords

References

  1. Alston SR, Fuller GN, Boyko OB : Ectopic renal tissue in a lumbosacral lipoma : Pathologic and radiologic findings. Pediatr Neurosci 15 : 100-103, 1989 https://doi.org/10.1159/000120451
  2. Blockey NJ, Schorstein J : Intraspinal epidermoid tumors in the lwnbar region of children. J Bone Joint Surg 43B: 556-562, 1961
  3. Chapman PH, Davis KR : Surgical treatment of spinal lipomas in childhood. In Raimondi AJ (ed) : Conceprs in Pediatric Neurosurgery. Basel, Karger, vol 3 : pp 178-190, 1983
  4. George RE, Hallinan HJ : Developmental anomalies. In Evans RW, Baskin DS, Yarsu FM (eds) : Prognosis of Developmental Disorders. New York, Oxford University Press : pp 411-443, 1992
  5. Gormley W, Tomecek F, Qureshi N : Craniocerebral epidermoid and dermoid rumors : A review of 32 cases. Acta Neurochir (Wien) 128: 1115-1121, 1994
  6. Hirt HR Zdrojewski B, Weber G : The manifestations and complications of intraspinal congerutal dermal sinuses and dermoid cysrs. Neuropadiatrie 3 : 231-247, 1971 https://doi.org/10.1055/s-0028-1091763
  7. Mary Kay GumerIock : Epidermoid, Dermoid, and Neurenteric Cysts. In Yownans Neurological Surgery (eds), Philadelphia, W.B. Saunders Co., ed 5 : pp 1223-1230, 2004
  8. McLone DG, Naidich TP : Spinal dysraphism : Experimental and clinical. In Holzmann RN, Stein BM (eds): The Tethered Spinal Cord. New York, Thieme-Stratton, pp 3-15, 1985
  9. Misago N, Abe M, Kohda H : Intradermal dermoid cyst associated with occult spinal dysraphism. J Dermatol 23 : 275-278, 1996 https://doi.org/10.1111/j.1346-8138.1996.tb04012.x
  10. Rossi A, Cama A, Piatelli G, Ravegnani M, Biancheri R, Torrori-Donari P : Spinal dysraphism : MR imaging rationale. J Neuroradiol 31 : 3-24, 2004 https://doi.org/10.1016/S0150-9861(04)96875-7
  11. Till K : Spinal dysraphism : a study of congenital malformations of the back. Dev Med Child Neurol 10 : 470-477, 1968 https://doi.org/10.1111/j.1469-8749.1968.tb02921.x
  12. Tortori- Donati P, Rossi A, Biancheri R, Cama A : Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging 12 : 375-409, 2001 https://doi.org/10.1097/00002142-200112000-00003
  13. WaIsh JW, Markesbery WR: Histological features of congenital lipornas of the lower spinal cord. J Neurosurg 52: 564-569, 1980 https://doi.org/10.3171/jns.1980.52.4.0564
  14. Walsh JW, Osterdock RJ : Lipomyelomeningocele. In Youmans Neurological Surgery (eds). Philadelphia, W.B. Saunders Co., ed 5 : pp 3229-3244, 2004
  15. Won GW, Kim SJ, Cho DS, Sea EK : Multiple lumbar intradermal dermoid cysts without spinal dysraphism. J Korean Neurosurg Soc 36 : 505-507, 2004