Spinal dermoid and epidermoid tumors: clinical series of 15 cases
Gokhan Cavus, Ismail Istemen, Vedat Acik, Emre Bilgin, Ali Arslan, Hakan Millet, Yurdal Gezercan, Ali Ihsan Okten
Adana City Training and Research Hospital, Neurosurgery Clinic, Adana, Turkey
Aim: Dermoid tumors are benign tumors originating from ectopic ectoderm and mesoderm remnants in the spinal tract. The congenital epidermoid cyst is considered to be developed as a result of ectodermal tissue inclusion during primitive neural tube enclosure. The aim of this study is to share our surgical results of spinal dermoid and epidermoid tumor cases performed in our clinic.
Material and Methods: 8 (53.3%) dermoid tumor and 7 (46.7%) epidermoid cases, which have been operated at our clinic between 2010 and 2015, were assessed retrospectively.
Results: 5 females (33.3%) and 10 males (66.7%) patients are included with an average age of 16.7 (1-43). The mass of 1 patient (6.7%) was cervical, 3 (20%) were thoracic, and 11 (73.3%) were lumber region located. One patient (6.7%), operated 7 years before at an outer site, applied for relapse in the lumbar region. Two patients (13.3%) had a dermal sinus tract. Three patients (20%) paraplegia and 4 patients (26.7%) had paraparesis preoperatively. Patients were evaluated using X-ray, spinal CT and spinal MRI tests. 3 patients (20%) with paraplegia were operated in emergency conditions. Intraoperative neuromonitorisation was performed. They were excised in 13 patients (86.7%) in total and 2 patients in subtotal. Two patients’ (13.3%) paraplegia improved in early period controls. No change occurred in 1 patient (6.7%). Four patients’ paralysisimproved (26.7%). One patient developed wound site infection (6.7%).
Conclusion: Dermoid tumors are rare benign congenital lesions. The purpose of the treatment is to excise the mass as total as possible without destructing the capsule. Subtotal excision is recommended rather the forming a neurological deficit.