Multi-Segmental Intramedullary Epidermoid Cyst Causing Low Back Pain and Urologic Dysfunction

Epidermoid cysts (ECs) are rare, slow growing tumors which usually affect lumbosacral area as an extramedullary lesion and mostly associated with spinal malformations. In this report we describe a very rare case of multi-segmental intramedullary EC.
A 42- year-old male presented with low back pain and paresthesia of left lower limb and also intermittent urinary retention. Urodynamic study showed weak contractions in bladder. MRI demonstrated multi-segmental lobulated intramedullary lesion extending from C7 to L2, which has high intensity on both T1 and T2-weighted images. Laminectomy of T11-L3 for symptomatic parts of the lesion and subtotal resection of the tumor was performed and histopathological investigation confirmed EC.
Prompt evaluation of every patient with combination of neurological and urologic disturbances should be carried out. This report suggests that rare intraspinal tumors such as EC may affect multiple locations of the spinal cord, thus appropriate surgical intervention may prevent unwanted sequelae.