Ruptured dermoid cyst of the conus medullaris in the myelomeningocele sac revealed at the initial repair surgery

  • Ai Kurogi
  • Takato MoriokaEmail author
  • Nobuya Murakami
  • Naoyuki Nakanami
  • Satoshi O. Suzuki
Case Report



Dermoid cysts in the myelomeningocele (MMC) site are thought to arise in a delayed fashion because of iatrogenic implantation of dermoid elements at the time of the initial repair surgery. However, there have been few reports on dermoid elements already present at birth.

Clinical presentation

We report a patient, in whom dermoid cyst was located at dorsal aspect of the conus medullaris in the MMC sac. Between 23+3 and 24+4 weeks of gestation, rupture of the MMC sac occurred. At this time of gestation, we speculate that rupture of the dermoid cyst also occurred and dissemination of the cyst contents caused chemical arachnoiditis in the MMC sac. At the age of 1 day, surgery to repair MMC and postoperative histological findings revealed these rare pathologies.


Physicians should be aware of the possibility of rupture of a dermoid cyst in the MMC sac during fetal period.


Arachnoiditis Cauda equina Keratin Squamous epithelium 



We thank Drs. Nobuko Kawamura, Takeshi Kusuda, and Rie Kikuno, Fukuoka Children’s Hospital, and Tadahisa Shono, Hara-Sanshin Hospital, for supporting our study. We thank Ellen Knapp, PhD, from Edanz Group (, for editing a draft of this manuscript.

Funding information

This work was partly supported by the Reseach Foundation of Fukuoka Children’s Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from the family of the infant described in this report.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryHara-Sanshin HospitalFukuokaJapan
  2. 2.Department of NeurosurgeryFukuoka Children’s HospitalFukuokaJapan
  3. 3.Department of ObstetricsFukuoka Children’s HospitalFukuokaJapan
  4. 4.Department of Neuropathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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