Neurosurgical Review

, Volume 28, Issue 4, pp 320–325 | Cite as

Dorsal intramedullary dermoids

  • Marwan W. NajjarEmail author
  • John A. Kusske
  • Anton N. Hasso
Case Report


We report a case of a 31-year-old woman with an intramedullary thoracic dermoid, who had progressive spastic paraparesis in her lower extremities over a period of three years, as well as loss of bowel and bladder control. She had been operated for “spina bifida” at three days of age but had no neurologic deficit. MRI of the thoracic spine showed an intramedullary hypointense lesion at T7–T8, associated with an intramedullary lipoma at a higher level. Intracapsular resection of an intramedullary dermoid cyst was performed. We review the literature on intramedullary dermoids differentiating them from the more common, but still rare, lumbosacral subdural juxtamedullary dermoids. We discuss the associated malformations with these lesions, as well as their pathophysiology and treatment. Although uncommon, dorsal intramedullary dermoids should be suspected and treated in a timely manner, especially in presence of other congenital anomalies.


Intramedullary dermoid Dermal sinus Congenital spinal malformation Spinal cord tumor 


  1. 1.
    Arseni C, Dânâilâ L, Constantinescu N, Carp N (1977) Spinal dermoid tumors. Neurochirurgia 20:108–116Google Scholar
  2. 2.
    Bailey IC (1970) Dermoid tumors of the spinal cord. J Neurosurg 33(6):676–681Google Scholar
  3. 3.
    Bradford FK (1938) Intramedullary dermoid cyst. Ann Surg 107:107–115Google Scholar
  4. 4.
    Falavigna A, Segatto AC, Salgado K (2001) A rare case of intramedullary lipoma associated with cyst. Arq Neuropsiquiatr 59(1):112–115Google Scholar
  5. 5.
    Gagliardi FM, Ferrari G (1969) Su un caso di dermoide intramidollare. Acta Neurochir 21:197–204Google Scholar
  6. 6.
    Graham DV, Tampieri D, Villemure JG (1988) Intramedullary dermoid tumor diagnosed with the assistance of magnetic resonance imaging. Neurosurgery 23(6):765–767Google Scholar
  7. 7.
    Gupta SK, Bhandari YP (1969) Intraspinal dermoids and epidermoids. Am J Roentgenol 105(2):386–389Google Scholar
  8. 8.
    Harriehausen H (1909) Über dermoide in wirbelkanal neben verdoppelung des rückenmarks. Dtsch Z Nervenheilkd 36:268–284Google Scholar
  9. 9.
    Iwasaki M, Yoshida Y, Shirane R, Yoshimoto T (2000) Spinal dermoid cyst secondary to myelomeningocele repair: a case report. No Shinkei Geka 28(2):155–160 (Abstract)Google Scholar
  10. 10.
    Kooistra HP, Rapids G (1942) Pilonidal sinuses occuring over the higher spinal segments with report of a case involving the spinal cord. Surgery 11:63–74Google Scholar
  11. 11.
    Kumar S, Gulati R, Mann S (1977) Intraspinal dermoids. Neurochirurgia 20:105–108Google Scholar
  12. 12.
    List CF (1941) Intraspinal epidermoids, dermoids, and dermal sinuses. Surg Gynecol Obstet 73:525–538Google Scholar
  13. 13.
    Lunardi P, Missori P, Gagliardi FM, Fortuna A (1989) Long term results of the surgical treatment of spinal dermoid and epidermoid tumors. Neurosurgery 25(6):860–864Google Scholar
  14. 14.
    Marinesco G, Draganesco S (1924) Kyste épidermoide cholestéatomateux de la moelle épinière coexistant avec un processus syringomyélique. Contribution a l’étude de la syringomyélie. Rev Neurol 2:338–355Google Scholar
  15. 15.
    Penisson-Besnier I, Guy G, Gandon Y (1989) Intramedullary epidermoid cyst evaluated by computed tomographic scan and magnetic resonance imaging: case report. Neurosurgery 25(6):955–959Google Scholar
  16. 16.
    Peter JC, Sinclair-Smith C, de Villiers JC (1991) Midline dermal sinuses and cysts and their relationship to the central nervous system. Eur J Pediatr Surg 1(2):73–79 (Abstract)Google Scholar
  17. 17.
    Roth M, Hanak L, Schroder R (1966) Intramedullary dermoid. J Neurol Neurosurg Psychiatry 29:262–264Google Scholar
  18. 18.
    Sachs E, Horrax G (1949) A cervical and a lumbar pilonidal sinus communicating with intraspinal demoids. Report of 2 cases and review of the literature. J Neurosurg 6:97–112Google Scholar
  19. 19.
    Sauerbruch F, Hartman F (1935) Beitrag zur chirurgie intramedullärer neubildungen. Schweiz Med Wochenschr 65:26–28Google Scholar
  20. 20.
    Shen WC, Chiou TL, Lin TY (2000) Dermal sinus with dermoid cyst in the upper cervical spine: case note. Neuroradiology 42(1):51–53Google Scholar
  21. 21.
    Takeuchi J, Ohta T, Kajikawa H (1978) Congenital tumors of the spinal cord. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 32, chap 13, North-Holland, Amsterdam, pp 355–392Google Scholar
  22. 22.
    Thurel R, Durupt L, Bourhis L (1952) Kyste dermoïde intramédullaire. Rev Neurol 86(4):339–341Google Scholar
  23. 23.
    Tytus JS, Pennybacker J (1956) Pearly tumors in relation to the central nervous system. J Neurol Neurosurg Psychiatry 19:241–259Google Scholar
  24. 24.
    Wilkins RH, Odom GL (1976) Spinal intradural cysts: epidermoid and dermoid cysts. In: Vinken PJ, Bryun GW (eds) Handbook of clinical neurology, vol 20, chap 4. North-Holland, Amsterdam, pp 73–82Google Scholar
  25. 25.
    Woods WW, Pimenta AM (1944) Intramedullary lesions of the spinal cord: study of sixty-eight consecutive cases. Arch Neurol Psychiatry 52:383–399Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Marwan W. Najjar
    • 1
    • 2
    Email author
  • John A. Kusske
    • 3
  • Anton N. Hasso
    • 4
  1. 1.Dr. Erfan and Bagedo HospitalsJeddahSaudi Arabia
  2. 2.Department of SurgeryAmerican University of BeirutBeirutLebanon
  3. 3.Department of Neurological SurgeryUniversity of CaliforniaIrvineUSA
  4. 4.University of CaliforniaIrvineUSA

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