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Erschienen in:
01.09.2014 | Neuro-Images
Isolated intramedullary cervical dermoid cyst
Erschienen in: Acta Neurologica Belgica | Ausgabe 3/2014
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A 65-year-old male was admitted because of 2-month history of left arm weakness. Spinal MRI showed a cervical intramedullary lesion whose features suggested a dermoid cyst (Fig. 1 a, b). No spinal dysraphisms were evident. At operation (under neurophysiological monitoring), after a C2–C5 laminotomy, dural opening and myelotomy, the lesion appeared composed of two components: cranially the cyst was filled with caseous yellowish and pearly material which was removed; caudally the lesion presented calcified material which was only partially removed because it was very adherent to the surrounding neural tissue (Fig. 1 c, d). Post-operative course was characterized by worsening of left arm weakness and onset of moderate weakness of legs. Histological examination confirmed the presence of keratin debris and bone suggesting a diagnosis of dermoid cyst.
Fig. 1
Spinal MRI showing the lesion composed by a dishomogeneous cranial portion hyperintense on T1-weighted images (a) and a caudal one mostly hypointense on T2-weighted sequences (b) with a pseudonodular contrast enhancement after gadolinium injection (not showed). On intraoperative view c the caseous and pearly material in the cranial portion of cyst and d the bony component in the caudal one are evident
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