PDF(Pubmed)
Abstract：
UNASSIGNED: Central nervous system tumors are usually located in the brain, and spinal cord tumors account for approximately 20% of central nervous system tumors. Epidermoid cysts constitute <1% of all intraspinal tumors. It consists of squamous epithelial-lined cysts containing keratin, cholesterol, and cellular granules. Epidermoid cysts can be classified as congenital, acquired, extradural, extramedullary, or intramedullary according to etiology and location. The intradural intramedullary type is uncommon.
UNASSIGNED: An 11-year-old female patient had back pain with radiation to both lower extremities but worsened on the left side for 5 years. On neurological examination, motor strength was 3/5 for hip flexion and knee extension bilaterally and 5/5 for other key muscle groups. Contrast-enhanced lumbosacral magnetic resonance imaging (MRI) revealed T1 hypointense and T2 hyperintense lesions in the L2-L4 intramedullary conus and cauda equina. Laminectomy and near total resection were done, and histopathological examination revealed an epidermoid cyst. On the third postoperative day, the patient was discharged with completely resolved back pain and an improvement in lower extremity motor power. At monthly follow-up visits for a further 6 months, her back pain and weakness completely resolved, and she had no neurologic deficits. A postoperative lumbosacral MRI was done and confirmed near total excision of the tumor.
UNASSIGNED: Intramedullary conus epidermoid cysts are rare but not unknown to neurosurgeons. MRI with diffusion-weighted images (DWI) is an imaging modality of choice. Asymptomatic patients can be conservatively treated. Once the patient has progressive symptoms and signs of compression, surgical excision is recommended. Meticulous electrocauterization may help decrease tumor regrowth in the remnant capsule, which is recommended. Avoiding leakage of cyst fluid into the subarachnoid space helps to avoid postoperative chemical meningitis. Radiotherapy is an option for the management of multiple recurrences.
UNASSIGNED: An 11-year-old female patient had back pain with radiation to both lower extremities but worsened on the left side for 5 years. On neurological examination, motor strength was 3/5 for hip flexion and knee extension bilaterally and 5/5 for other key muscle groups. Contrast-enhanced lumbosacral magnetic resonance imaging (MRI) revealed T1 hypointense and T2 hyperintense lesions in the L2-L4 intramedullary conus and cauda equina. Laminectomy and near total resection were done, and histopathological examination revealed an epidermoid cyst. On the third postoperative day, the patient was discharged with completely resolved back pain and an improvement in lower extremity motor power. At monthly follow-up visits for a further 6 months, her back pain and weakness completely resolved, and she had no neurologic deficits. A postoperative lumbosacral MRI was done and confirmed near total excision of the tumor.
UNASSIGNED: Intramedullary conus epidermoid cysts are rare but not unknown to neurosurgeons. MRI with diffusion-weighted images (DWI) is an imaging modality of choice. Asymptomatic patients can be conservatively treated. Once the patient has progressive symptoms and signs of compression, surgical excision is recommended. Meticulous electrocauterization may help decrease tumor regrowth in the remnant capsule, which is recommended. Avoiding leakage of cyst fluid into the subarachnoid space helps to avoid postoperative chemical meningitis. Radiotherapy is an option for the management of multiple recurrences.
摘要：
■中枢神经系统肿瘤通常位于大脑中，脊髓肿瘤约占中枢神经系统肿瘤的20%。表皮样囊肿占所有椎管内肿瘤的<1%。它由含有角蛋白的鳞状上皮衬里囊肿组成，胆固醇,和细胞颗粒。表皮样囊肿可以归类为先天性，收购，硬膜外,髓外,或髓内根据病因和位置。硬膜内髓内型并不常见。
■一名11岁的女性患者因双下肢放射而背痛，但在左侧恶化了5年。在神经系统检查中，双侧髋关节屈曲和膝关节伸展的运动强度为3/5，其他关键肌群的运动强度为5/5。对比增强的腰s磁共振成像（MRI）显示L2-L4髓内圆锥和马尾的T1低信号和T2高信号病变。进行了椎板切除术和近乎全切除术，组织病理学检查发现表皮样囊肿。术后第三天,患者出院,背痛完全缓解,下肢运动功率改善.在每月随访6个月时，她的背痛和虚弱完全解决了，她没有神经缺陷.术后进行了腰s部MRI检查，并证实了肿瘤的完全切除。
■髓内圆锥表皮样囊肿是罕见的，但并不是神经外科医生所不知道的。具有弥散加权图像（DWI）的MRI是一种首选的成像方式。无症状患者可以保守治疗。一旦患者出现进行性症状和压迫迹象，建议手术切除。细致的电烧灼可能有助于减少残囊中的肿瘤再生长，这是推荐的。避免囊肿液泄漏到蛛网膜下腔有助于避免术后化学性脑膜炎。放射治疗是管理多次复发的一种选择。
■一名11岁的女性患者因双下肢放射而背痛，但在左侧恶化了5年。在神经系统检查中，双侧髋关节屈曲和膝关节伸展的运动强度为3/5，其他关键肌群的运动强度为5/5。对比增强的腰s磁共振成像（MRI）显示L2-L4髓内圆锥和马尾的T1低信号和T2高信号病变。进行了椎板切除术和近乎全切除术，组织病理学检查发现表皮样囊肿。术后第三天,患者出院,背痛完全缓解,下肢运动功率改善.在每月随访6个月时，她的背痛和虚弱完全解决了，她没有神经缺陷.术后进行了腰s部MRI检查，并证实了肿瘤的完全切除。
■髓内圆锥表皮样囊肿是罕见的，但并不是神经外科医生所不知道的。具有弥散加权图像（DWI）的MRI是一种首选的成像方式。无症状患者可以保守治疗。一旦患者出现进行性症状和压迫迹象，建议手术切除。细致的电烧灼可能有助于减少残囊中的肿瘤再生长，这是推荐的。避免囊肿液泄漏到蛛网膜下腔有助于避免术后化学性脑膜炎。放射治疗是管理多次复发的一种选择。
