Purpose Intraspinal epidermoid cysts (IEC) are cystic tumours lined by squamous epithelium that do not contain skin appendages [1]. IEC is uncommon, comprising 0.5-1% of all spinal tumours in patients of all ages, up to 10% in paediatrics and are more prevalent in males [2,3]. IEC may be intra or extramedullary and are usually congenital in origin [2]. IEC are slow-growing, indolent lesions that are usually benign and rarely malignant transformation has been reported [4-5]. IECs are commonly associated with congenital spinal dysraphism such as...

Patient Presentation A 6 years-old male patient presented with ataxia (two weeks duration). No significant past medical history. The patient was born at term and has no clinical features of recent viral infection. Vaccination records were up to date. On physical examination, a skin dimple was noted over the T2 spinous process. The patient exhibited a wide, broad-based ataxic gait with an inability to heel walk with his right foot. He had bilateral up-going plantar responses and reduced strength in his right leg. Namely, he...

MRI of the whole spine revealed an ovoid, well-circumscribed intraspinal lesion measuring 40mm x 15mm extending from the level of T1 to T4 with superior spinal cord draped over the lesion and inferior cord ventrally displaced by the lesion. The lesion was T2 hypointense, T1 hyperintense, showed DWI restriction and no post-contrast enhancement (figure 1). The T2 hyperintense tract extended caudally between the T3 and T4 spinous processes, consistent with DST (figure 2). The patient underwent emergency resection and a gelatinous cystic tumour connected to...

In closing, we present a rare IEC with an associated DST at an unusual location in the upper thoracic spine and highlight the utility of diffusion weighted MRI to make an accurate pre-operative diagnosis which assisted in surgical planning to excise both the IEC and the DST

Grossman RI, Yousem DM. Neuroradiology, the requisites. Mosby Inc. (2003) ISBN:032300508X. Celik AO, Baris MM, Demirtas H, Umul A. Unusual case of spinal epidermoid cyst and a concomitant spinal arachnoid cyst. BMJ Case Reports. 2016;2016:bcr2015214002. Morbée L, Lagae P, Smet B, Baelde N, De Mey J. A congenital spinal epidermoid cyst. Journal of the Belgian Society of Radiology. 2015;99:127-128. Seif B, Pourkhalili R, Shekarchizadeh A, et al. Malignant transformation of an intracranial extradural epidermoid cyst into squamous cell carcinoma presented with cerebrospinal fluid leakage. Adv...