• Octavian-Mihai Sîrbu, Alin-Vasile Chirteş, Marian Mitricã, and Carmen-Adella Sîrbu.
• Department of Neurosurgery, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania. Electronic address: octaviansirbu@gmail.com.
• World Neurosurg. 2020 Jul 1; 139: 39-50.

BackgroundEpidermoid cysts are rare benign neoplasms within the neuroaxis and account for <1% of all intraspinal tumors. They can be congenital or acquired. Being a slow-growing tumor, the clinical presentation is widely variable depending on the location, size, or age of the patient.ObjectivesBecause of the rarity of this entity, the diagnosis and treatment are often delayed. We wanted to offer an updated overall view on spinal epidermoid cysts to facilitate diagnosis and treatment decisions.MethodsWe present the case of a patient with thoracic intramedullary epidermoid cyst and we conduct a review of reported cases in the literature using PubMed database.ResultsFrom 1962 to September 2019, we gathered 91 articles with a total of 139 cases (ours included). There is a slightly female predominance and a bimodal age distribution. Acquired cysts are seen in 38.1% of patients. The most frequent symptom was pain, followed by motor deficit, sensitive deficits, and sphincter deficiencies. The mean time delay to diagnosis is 26.36 ± 53.29 months. The most common localization was in the lumbar area and one third of the tumors were intramedullary. A good outcome was achieved in most of the treated cases.ConclusionsTo achieve a good outcome, an early recognition of this disease is essential. The management consists in most cases of surgical resection. Although recurrence is low, it can significantly alter the quality of life of our patients, and, therefore, gross total resection should be our goal.Copyright © 2020 Elsevier Inc. All rights reserved.

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