Abstract

Background: Intramedullary dermoid cyst is a type of rare congenital intraspinal lesions especially those located in the conus medullaris and not associated with spinal dysraphism. The Management of DC is especially difficult in eloquent areas such as the conus medullaris, with tendency to recurrence and poorly respond to oncologic treatment.

Objective: We aim to provide a summary of the pathology, clinical presentation, and management strategies of dermoid cysts involving the conus medullaris with review of the literature.

Case presentation: A 37-year-old woman presented with progressive low back pain and loss of bowel and bladder function. His magnetic resonance imaging (MRI) scan showed a heterogeneous tumor with tethering of the spinal cord. He was taken for a midline myelotomy that drained yellowish keratinous fluid and decompressed the cyst. No aggressive attempt at complete resection of the cyst wall was undertaken. She made a complete recovery after surgery with complete resolution of her symptoms.

Conclusion: Dermoid cyst of the conus medullaris without any congenital spinal dysraphism make this case unique. Surgical control and restraint are the key for optimal management and good recovery.

Keywords: Dermoid cyst; Conus medullaris; Spinal tumor; Intramedullary

Abbreviations: DC: Dermoid Cyst; MRI: Magnetic Resonance Imaging