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Epidermoid Cyst
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Epidermoid tumor
              • Definitions

                • Benign, nonneoplastic spinal mass composed of cells embryologically derived from epidermal (skin) elements

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Beechar VB et al: Spinal epidermoid tumors: case report and review of the literature. Neurospine. 15(2):117-22, 2018
                                                2. Funao H et al: A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature. World J Surg Oncol. 15(1):131, 2017
                                                3. Park MH et al: Iatrogenic intraspinal epidermoid cyst. Korean J Spine. 11(3):195-7, 2014
                                                4. Yin H et al: Surgery and outcomes of six patients with intradural epidermoid cysts in the lumbar spine. World J Surg Oncol. 12(1):50, 2014
                                                5. Velamati R et al: Meningitis secondary to ruptured epidermoid cyst: case-based review. Pediatr Ann. 42(6):248-51, 2013
                                                6. Morita M et al: Intraspinal epidermoid tumor of the cauda equina region: seven cases and a review of the literature. J Spinal Disord Tech. 25(5):292-8, 2012
                                                7. Gonzalvo A et al: Intramedullary spinal epidermoid cyst of the upper thoracic region. J Clin Neurosci. 16(1):142-4, 2009
                                                8. Bernard PA: Lumbar punctures: always use a stylette. J Child Neurol. 23(8):969; author reply 969, 2008
                                                9. Danzer E et al: Intradural inclusion cysts following in utero closure of myelomeningocele: clinical implications and follow-up findings. J Neurosurg Pediatr. 2(6):406-13, 2008
                                                10. Manara R et al: Chronic cystic lesion of the sacrum: characterisation with diffusion-weighted MR imaging. Radiol Med. 113(5):739-46, 2008
                                                11. Piana G et al: Epidermoid-cyst of the conus medullaris: usefulness of DWI. J Neuroradiol. 35(5):304-5, 2008
                                                12. Tekkök IH: Intramedullary epidermoid cysts. J Neurosurg Spine. 8(2):202-3; author reply 203, 2008
                                                13. Yen CP et al: Epidermoid cysts associated with thoracic meningocele. Acta Neurochir (Wien). 150(3):305-8; discussion 308-9, 2008
                                                14. Gao B et al: Mollaret meningitis associated with an intraspinal epidermoid cyst. Pediatrics. 120(1):e220-4, 2007
                                                15. Gerlach R et al: Large intramedullary abscess of the spinal cord associated with an epidermoid cyst without dermal sinus. Case report. J Neurosurg Spine. 7(3):357-61, 2007
                                                16. Kukreja K et al: Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful? Pediatr Radiol. 37(6):556-60, 2007
                                                17. Ogden AT et al: Intramedullary inclusion cysts of the cervicothoracic junction. Report of two cases in adults and review of the literature. J Neurosurg Spine. 7(2):236-42, 2007
                                                18. Per H et al: Iatrogenic epidermoid tumor: late complication of lumbar puncture. J Child Neurol. 22(3):332-6, 2007
                                                19. Rajpal S et al: Tethering tracts in spina bifida occulta: revisiting an established nomenclature. J Neurosurg Spine. 7(3):315-22, 2007
                                                20. Refai D et al: Iatrogenic intradural epidermoid cyst after lumbar puncture. Case illustration. J Neurosurg. 106(4 Suppl):322, 2007
                                                21. Jeong IH et al: Iatrogenic intraspinal epidermoid tumor: case report. Pediatr Neurosurg. 42(6):395-8, 2006
                                                22. Tang L et al: Diffusion-weighted imaging distinguishes recurrent epidermoid neoplasm from postoperative arachnoid cyst in the lumbosacral spine. J Comput Assist Tomogr. 30(3):507-9, 2006
                                                23. Lai SW et al: MRI of epidermoid cyst of the conus medullaris. Spinal Cord. 43(5):320-3, 2005
                                                24. Bretz A et al: Intraspinal epidermoid cyst successfully treated with radiotherapy: case report. Neurosurgery. 53(6):1429-31; discussion 1431-2, 2003
                                                25. Park JC et al: Iatrogenic spinal epidermoid tumor. A complication of spinal puncture in an adult. Clin Neurol Neurosurg. 105(4):281-5, 2003
                                                26. Amato VG et al: Intramedullary epidermoid cyst: preoperative diagnosis and surgical management after MRI introduction. Case report and updating of the literature. J Neurosurg Sci. 46(3-4):122-6, 2002
                                                27. Avellino AM et al: FLAIR magnetic resonance image of a pediatric spinal epidermoid cyst. Pediatr Neurosurg. 36(4):220-2, 2002
                                                28. Avellino AM et al: Diffusion-weighted magnetic resonance image of a pediatric spinal epidermoid cyst. Pediatr Neurosurg. 34(6):325-6, 2001
                                                29. Teksam M et al: Intraspinal epidermoid cyst: diffusion-weighted MRI. Neuroradiology. 43(7):572-4, 2001
                                                30. Song JH et al: Intraspinal epidermoid cyst occurring 15 years after lipomyelomeningocele repair. Case report. J Neurosurg. 90(2 Suppl):252-4, 1999
                                                31. Potgieter S et al: Epidermoid tumours associated with lumbar punctures performed in early neonatal life. Dev Med Child Neurol. 40(4):266-9, 1998
                                                32. Debray MP et al: Epidermoid cyst of the conus medullaris: atypical MRI and angiographic features. Neuroradiology. 38(6):526-8, 1996
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Synonyms

                                                              • Epidermoid tumor
                                                            • Definitions

                                                              • Benign, nonneoplastic spinal mass composed of cells embryologically derived from epidermal (skin) elements

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Nonvascular Interventions

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Beechar VB et al: Spinal epidermoid tumors: case report and review of the literature. Neurospine. 15(2):117-22, 2018
                                                                                              2. Funao H et al: A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature. World J Surg Oncol. 15(1):131, 2017
                                                                                              3. Park MH et al: Iatrogenic intraspinal epidermoid cyst. Korean J Spine. 11(3):195-7, 2014
                                                                                              4. Yin H et al: Surgery and outcomes of six patients with intradural epidermoid cysts in the lumbar spine. World J Surg Oncol. 12(1):50, 2014
                                                                                              5. Velamati R et al: Meningitis secondary to ruptured epidermoid cyst: case-based review. Pediatr Ann. 42(6):248-51, 2013
                                                                                              6. Morita M et al: Intraspinal epidermoid tumor of the cauda equina region: seven cases and a review of the literature. J Spinal Disord Tech. 25(5):292-8, 2012
                                                                                              7. Gonzalvo A et al: Intramedullary spinal epidermoid cyst of the upper thoracic region. J Clin Neurosci. 16(1):142-4, 2009
                                                                                              8. Bernard PA: Lumbar punctures: always use a stylette. J Child Neurol. 23(8):969; author reply 969, 2008
                                                                                              9. Danzer E et al: Intradural inclusion cysts following in utero closure of myelomeningocele: clinical implications and follow-up findings. J Neurosurg Pediatr. 2(6):406-13, 2008
                                                                                              10. Manara R et al: Chronic cystic lesion of the sacrum: characterisation with diffusion-weighted MR imaging. Radiol Med. 113(5):739-46, 2008
                                                                                              11. Piana G et al: Epidermoid-cyst of the conus medullaris: usefulness of DWI. J Neuroradiol. 35(5):304-5, 2008
                                                                                              12. Tekkök IH: Intramedullary epidermoid cysts. J Neurosurg Spine. 8(2):202-3; author reply 203, 2008
                                                                                              13. Yen CP et al: Epidermoid cysts associated with thoracic meningocele. Acta Neurochir (Wien). 150(3):305-8; discussion 308-9, 2008
                                                                                              14. Gao B et al: Mollaret meningitis associated with an intraspinal epidermoid cyst. Pediatrics. 120(1):e220-4, 2007
                                                                                              15. Gerlach R et al: Large intramedullary abscess of the spinal cord associated with an epidermoid cyst without dermal sinus. Case report. J Neurosurg Spine. 7(3):357-61, 2007
                                                                                              16. Kukreja K et al: Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful? Pediatr Radiol. 37(6):556-60, 2007
                                                                                              17. Ogden AT et al: Intramedullary inclusion cysts of the cervicothoracic junction. Report of two cases in adults and review of the literature. J Neurosurg Spine. 7(2):236-42, 2007
                                                                                              18. Per H et al: Iatrogenic epidermoid tumor: late complication of lumbar puncture. J Child Neurol. 22(3):332-6, 2007
                                                                                              19. Rajpal S et al: Tethering tracts in spina bifida occulta: revisiting an established nomenclature. J Neurosurg Spine. 7(3):315-22, 2007
                                                                                              20. Refai D et al: Iatrogenic intradural epidermoid cyst after lumbar puncture. Case illustration. J Neurosurg. 106(4 Suppl):322, 2007
                                                                                              21. Jeong IH et al: Iatrogenic intraspinal epidermoid tumor: case report. Pediatr Neurosurg. 42(6):395-8, 2006
                                                                                              22. Tang L et al: Diffusion-weighted imaging distinguishes recurrent epidermoid neoplasm from postoperative arachnoid cyst in the lumbosacral spine. J Comput Assist Tomogr. 30(3):507-9, 2006
                                                                                              23. Lai SW et al: MRI of epidermoid cyst of the conus medullaris. Spinal Cord. 43(5):320-3, 2005
                                                                                              24. Bretz A et al: Intraspinal epidermoid cyst successfully treated with radiotherapy: case report. Neurosurgery. 53(6):1429-31; discussion 1431-2, 2003
                                                                                              25. Park JC et al: Iatrogenic spinal epidermoid tumor. A complication of spinal puncture in an adult. Clin Neurol Neurosurg. 105(4):281-5, 2003
                                                                                              26. Amato VG et al: Intramedullary epidermoid cyst: preoperative diagnosis and surgical management after MRI introduction. Case report and updating of the literature. J Neurosurg Sci. 46(3-4):122-6, 2002
                                                                                              27. Avellino AM et al: FLAIR magnetic resonance image of a pediatric spinal epidermoid cyst. Pediatr Neurosurg. 36(4):220-2, 2002
                                                                                              28. Avellino AM et al: Diffusion-weighted magnetic resonance image of a pediatric spinal epidermoid cyst. Pediatr Neurosurg. 34(6):325-6, 2001
                                                                                              29. Teksam M et al: Intraspinal epidermoid cyst: diffusion-weighted MRI. Neuroradiology. 43(7):572-4, 2001
                                                                                              30. Song JH et al: Intraspinal epidermoid cyst occurring 15 years after lipomyelomeningocele repair. Case report. J Neurosurg. 90(2 Suppl):252-4, 1999
                                                                                              31. Potgieter S et al: Epidermoid tumours associated with lumbar punctures performed in early neonatal life. Dev Med Child Neurol. 40(4):266-9, 1998
                                                                                              32. Debray MP et al: Epidermoid cyst of the conus medullaris: atypical MRI and angiographic features. Neuroradiology. 38(6):526-8, 1996