Spinal congenital dermal sinus associated with upper thoracic meningocele

The congenital dermal sinus is an abnormal epithelium-lined sinus tract between the skin surface and deeper tissues. It occurs during neurulation when the neural groove closes to form the neural tube on Day 26 of gestation and results from a failure of neuroectoderm to separate from the cutaneous ectoderm. The most frequent location is the lumbosacral area; an upper thoracic location is quite rare. This 37-year-old man presented with headache and numbness in both arms. No specific neurological findings were observed. Physical examination revealed a dimple at T-2. Radiography and magnetic resonance imaging of the thoracic spine revealed spina bifida at T1–3, a meningocele, and a dermal sinus tract complex. The treatment approach and outcome in this unusual case are presented.

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

Case Reports in Radiology ◽

10.1155/2013/878713 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Michael G. Fazio ◽

Alyson M. Kil ◽

Veronica J. Rooks ◽

Timothy J. Biega

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Epidermoid Cyst ◽

Sinus Tract ◽

Magnetic Resonance Images ◽

Dermal Sinus ◽

Resonance Imaging ◽

Diffusion Weighted ◽

Dermal Sinus Tract ◽

Weighted Magnetic Resonance Imaging

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.

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Dermal Sinus Tract of Lumbosacral Spine in Children: Patterns on Magnetic Resonance Imaging and Scoring System

Cureus ◽

10.7759/cureus.1906 ◽

2017 ◽

Author(s):

Jessica Lane ◽

Mark Dias ◽

Mark Iantosca ◽

Thomas Zacharia ◽

R. Shane Tubbs ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Scoring System ◽

Sinus Tract ◽

Lumbosacral Spine ◽

Dermal Sinus ◽

Resonance Imaging ◽

Dermal Sinus Tract

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CONGENITAL PTERIONAL DERMAL SINUS IN AN 18-MONTH-OLD CHILD

Neurosurgery ◽

10.1227/01.neu.0000290921.93588.87 ◽

2007 ◽

Vol 61 (3) ◽

pp. E661-E661 ◽

Cited By ~ 5

Author(s):

William J. Mack ◽

Saadi Ghatan

Keyword(s):

Clinical Features ◽

Neural Tube ◽

Clinical Presentation ◽

Sinus Tract ◽

Dermal Sinus ◽

Operating Microscope ◽

First Case ◽

Dermal Sinus Tract ◽

Cranial Fossa ◽

Congenital Dermal Sinus

Abstract OBJECTIVE Congenital dermal sinus tracts most frequently occur in the midline and are often associated with dermoid or epidermoid inclusion cysts. A lateral cranial origin is extremely rare and anatomically inconsistent with an etiology involving closure of the rostral neural tube during embryogenesis. CLINICAL PRESENTATION We describe the first case of a pterional cranial dermal sinus tract associated with a small epidermoid, with extension to the dura of the anterior cranial fossa. INTERVENTION The extra- and intracranial portions of the tract were visualized and resected with the use of an operating microscope. Pathological diagnosis confirmed dermal sinus tract. CONCLUSION We review the existing literature and address the developmental and clinical features pertinent to the management of cranial dermal sinus tracts, emphasizing the need for exploration of these potentially harmful lesions.

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