Intradural extramedullary epidermoid cyst at cauda equina level in 2-years female child: A rare case report

International Journal of Surgery Case Reports, 2025 · DOI: https://doi.org/10.1016/j.ijscr.2025.110986 · Published: January 29, 2025

Surgery Pediatrics Research Methodology & Design

Simple Explanation

Spinal epidermoid cysts are uncommon, noncancerous growths. This case reports a rare instance in a 2-year-old female where such a cyst was found in the intradural extramedullary region of the spine, specifically at the cauda equina level. The child presented with a skin fold on the back since birth, leading to an MRI which revealed the cyst. The cyst was surgically removed, and the diagnosis was confirmed through histological examination. Post-surgery, the patient experienced temporary neurogenic bladder dysfunction, which was managed with urological consultation and bladder training. The patient returned to baseline with no signs of deterioration.

Study Duration

Not specified

Participants

A 2-year-old female child

Evidence Level

Case Report

Key Findings

1
The patient presented with a rare intradural extramedullary epidermoid cyst at the L3-L4 level of the cauda equina, identified via lumbosacral MRI.
2
Histological examination of the surgically removed tumor confirmed the diagnosis of an epidermoid cyst, characterized by squamous epithelium and keratin masses.
3
Post-operative neurogenic bladder dysfunction was successfully managed with bladder training and urological consultation, leading to the patient's recovery.

Research Summary

This case report describes a rare instance of an intradural extramedullary epidermoid cyst at the cauda equina level in a 2-year-old female, presenting with a skin fold on the back since birth. The cyst was successfully removed via laminectomy and durotomy, with histological examination confirming the diagnosis. Post-operative neurogenic bladder dysfunction was managed with rehabilitation and urological intervention. The case highlights the importance of MRI in diagnosing spinal ECs and emphasizes that complete surgical removal is the preferred treatment to prevent further neurological deficits and disease recurrence.

Practical Implications

Early Diagnosis via MRI

MRI is a valuable tool for diagnosing spinal ECs, enabling early detection and intervention.

Complete Surgical Removal

Surgery by total removal is the treatment of choice for spinal ECs, providing a disease-free outcome.

Post-operative Monitoring

Performing post-operative MRI and monitoring tumor markers can provide valuable information for recurrence.

Study Limitations

1
Single case report limits generalizability.
2
Lack of post-operative MRI due to patient uncooperativeness and financial constraints.
3
Limited follow-up duration.

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