Ruptured dermoid cyst of the conus medullaris in the myelomeningocele sac revealed at the initial repair surgery
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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.
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.
KeywordsArachnoiditis 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 (www.edanzediting.com/ac), for editing a draft of this manuscript.
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 was obtained from the family of the infant described in this report.