Long standing lumbosacral dermoid tumor and intracranial fat droplet dissemination: A case report

BACKGROUND: Dermoid tumors are slow growing, benign CNS lesions. CASE DESCRIPTION: This case study concerns a 29-year-old female with a 6-year history of lower extremity paresthesias attributed to magnetic resonance (MR)/computed tomography (CT) documented intradural dermoid tumor that extended from L1 to S1. On MR, it was hypointense on T1, hyperintense on T2, and did not enhance with gadolinium. CT showed hyperdensity at the L1-L2 levels. The craniocervical MR imaging showed small hyperintense foci in the cisternal space favoring “fat dissemination.” L1-S2 laminectomy revealed an intradural lesion characterized by “a solid and firm component compatible with fat tissue adherent to the conus medullaris and a solid-soft component within the cauda equina;” there were also “multiple fragments of white-creamy soft tissue with hair.” Following tumor resection, the brain CT scan demonstrated fat dissemination within the intraventricular and cisternal space. Histopathologic examination confirmed the diagnosis of a dermoid tumor. CONCLUSION: Dermoid tumors should be considered among the differential diagnosis of intradural lesions in young patients even without any other congenital abnormality.