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Case Reports in Radiology
Volume 2013 (2013), Article ID 878713, 3 pages
http://dx.doi.org/10.1155/2013/878713
Case Report

Diffusion-Weighted Magnetic Resonance Imaging of an Intramedullary Epidermoid Cyst with Dorsal Dermal Sinus Tract in a Toddler

1Department of Radiology, MCHK-DR, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA
2Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Received 31 July 2013; Accepted 27 August 2013

Academic Editors: C. Chaskis and E. Kocakoc

Copyright © 2013 Michael G. Fazio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report the use of diffusion-weighted magnetic resonance imaging to diagnose and manage a rare case of a symptomatic thoracic intramedullary congenital epidermoid cyst with associated dermal sinus in a girl. Congenital intramedullary epidermoid cysts with associated dermal sinuses are very rare occurrences and seldom present symptomatically in very young children. We present a case of a 32-month old with a draining dimpled skin lesion. Magnetic resonance images demonstrated an intramedullary epidermoid with a dorsal dermal sinus tract opening to the skin surface which was confirmed surgically. The patient was treated with debulking to prevent recurrent infection and progression of neurological symptoms. This case demonstrates the use of diffuse-weighted MRI to assist in the diagnosis and surgical management of an atypical presentation of a rare developmental abnormality, which is not well documented in the pediatric radiological literature. Failure to diagnosis may have significant neurological permanent debilitating consequences.