Long segment cervicothoracic intramedullary dermoid with concomitant conal lesion – A case report

BACKGROUND: Spinal dermoid cysts are benign tumors that result from congenital or acquired ectodermal inclusions. Long segment intramedullary involvement of the spinal cord is exceedingly rare, and there are only a handful of case reports found in the literature. CASE DESCRIPTION: A 30-year-old female presented with a 3-month history of myelopathy characterized by progressive quadriparesis and urinary incontinence. Magnetic resonance imaging revealed multifocal heterogeneous intramedullary masses extending from C2 to T4 and at T12–L1 with similar intensity lesions seen within the central cord from T5 to T11 level. Following tumor decompression, she showed significant improvement in neurological function 1 month later. The histopathological examination confirmed the diagnosis of a multifocal intramedullary dermoid cyst. CONCLUSION: Partial surgical extirpation is a reasonable treatment for long segment intramedullary dermoid cysts, particularly when the tumor capsule is adherent to critical adjacent neural tissues.