Abstract
Background
Dermoid cysts in the myelomeningocele (MMC) site are thought to arise in a delayed fashion because of iatrogenic implantation of dermoid elements at the time of the initial repair surgery. However, there have been few reports on dermoid elements already present at birth.
Clinical presentation
We report a patient, in whom dermoid cyst was located at dorsal aspect of the conus medullaris in the MMC sac. Between 23+3 and 24+4 weeks of gestation, rupture of the MMC sac occurred. At this time of gestation, we speculate that rupture of the dermoid cyst also occurred and dissemination of the cyst contents caused chemical arachnoiditis in the MMC sac. At the age of 1 day, surgery to repair MMC and postoperative histological findings revealed these rare pathologies.
Conclusion
Physicians should be aware of the possibility of rupture of a dermoid cyst in the MMC sac during fetal period.
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References
Scott RM, Wolpert SM, Bartoshesky LE, Zimbler S, Klauber GT (1986) Dermoid tumors occurring at the site of previous myelomeningocele repair. J Neurosurg 65:779–783
Fiaschi P, Piatelli G, Cama A, Capra V, Consales A, Ravegnani M, Pavanello M (2019) Intraspinal inclusion tumor after myelomeningocele repair: a long-term single-center experience. World Neurosurg 122:e1338–e1344
Chadduck WM, Roloson GJ (1993) Dermoid in the filum terminale of a newborn with myelomeningocele. Pediatr Neurosurg 19:81–83
Ramos E, Marlin AE, Gaskill SJ (2008) Congenital dermoid tumor in a child at initial myelomeningocele closure: an etiological discussion. Case report. J Neurosurg Pediatrics 2:414–415
Storrs BB (1994) Are dermoid and epidermoid tumors preventable complications of myelomeningocele repair? Pediatr Neurosurg 20:160–162
Lunardi P, Missori P (1990) Cranial and spinal tumors with meningitic onset. Ital J Neurol Sci 11:145–1514
Acknowledgments
We thank Drs. Nobuko Kawamura, Takeshi Kusuda, and Rie Kikuno, Fukuoka Children’s Hospital, and Tadahisa Shono, Hara-Sanshin Hospital, for supporting our study. We thank Ellen Knapp, PhD, from Edanz Group (www.edanzediting.com/ac), for editing a draft of this manuscript.
Funding
This work was partly supported by the Reseach Foundation of Fukuoka Children’s Hospital.
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Informed consent was obtained from the family of the infant described in this report.
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Kurogi, A., Morioka, T., Murakami, N. et al. Ruptured dermoid cyst of the conus medullaris in the myelomeningocele sac revealed at the initial repair surgery. Childs Nerv Syst 36, 1061–1065 (2020). https://doi.org/10.1007/s00381-019-04428-1
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DOI: https://doi.org/10.1007/s00381-019-04428-1