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Presented by Peter Illei, M.D. and prepared by Shiyama Mudali, M.D.
Case 2: 29-year-old female who underwent L2 laminectomy and resection of an intradural extramedullary tumor.
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Question 1 of 1
1. Question
Week 472: Case 2
29-year-old female who underwent L2 laminectomy and resection of an intradural extramedullary tumor.images/1alex/03212011case2image1.jpg
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images/1alex/03212011case2image5.jpgCorrect
Answer: Epidermoid cyst
Histology: Sections show a keratinizing stratified squamous epithelial lined cyst that is filled with keratineceous debris and is surrounded be dense fibrous tissue. Scattered foci of foreign body giant cell reactions with associated mild chronic inflammation surrounding acellular keratinaceous debris also noted. No skin adnexal structures are present. The findings are diagnostic of intradural extramedullary epidermoid cyst.
Discussion: Ectoderm derived neuroaxis cysts can be divided in to epidermoid (no adnexa present) and Dermoid cyst (adenxa present). They arise from the surface ectodermal elements or can be iatrogenic. Epidermal cysts can be found in all ages with a peak in young adults and middle aged people. Dermoid cysts are more common in children and adolescents and are usually midline lesions. Intraspinal epidermal cysts can be intra and extradural. Cyst rupture is not uncommon.
Incorrect
Answer: Epidermoid cyst
Histology: Sections show a keratinizing stratified squamous epithelial lined cyst that is filled with keratineceous debris and is surrounded be dense fibrous tissue. Scattered foci of foreign body giant cell reactions with associated mild chronic inflammation surrounding acellular keratinaceous debris also noted. No skin adnexal structures are present. The findings are diagnostic of intradural extramedullary epidermoid cyst.
Discussion: Ectoderm derived neuroaxis cysts can be divided in to epidermoid (no adnexa present) and Dermoid cyst (adenxa present). They arise from the surface ectodermal elements or can be iatrogenic. Epidermal cysts can be found in all ages with a peak in young adults and middle aged people. Dermoid cysts are more common in children and adolescents and are usually midline lesions. Intraspinal epidermal cysts can be intra and extradural. Cyst rupture is not uncommon.
