• Takuma Maeda, Kazuhiko Mishima, Jungo Imanishi, Mitsuaki Shirahata, Tomonari Suzuki, Jun-Ichi Adachi, Atsushi Sasaki, and Ryo Nishikawa.
• Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan. Electronic address: miyuki.yuming@gmail.com.
• World Neurosurg. 2019 Jul 1; 127: 113-116.

BackgroundSpinal epidermoid cysts are very rare tumors, especially in the thoracic spine; they represent 0.8% of all spinal epidermoids. In adult cases, they are often associated with surgical procedures such as lumbar puncture. We report a rare case of spinal epidermoid cyst in the thoracic spine of an elderly patient who had never undergone lumber puncture, thoracic spinal surgery, or trauma.Case DescriptionA 78-year old woman presented with a 1-month history of rapidly progressive impairment of sensation in both the lower limbs, with gait disturbance. She had no history of spinal surgery, trauma, or lumbar puncture. Her past medical history was unremarkable. Magnetic resonance imaging of the whole spine revealed an intraspinalextramedullary tumor at the Th 1-2 level. Diffusion-weighted imaging revealed significant homogeneous high intensity. We performed complete resection without damaging the spinal cord or nerve roots. The final histological examination indicated epidermoid cyst without malignancy. Her gait disturbance was completely resolved at 4-month follow-up.ConclusionsEpidermoid cysts must be considered among spinal tumors in elderly patients. Early detection by diffusion-weighted imaging and complete resection may lead to good neurological outcome.Copyright © 2019 Elsevier Inc. All rights reserved.

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