A 10-MONTH-OLD boy presented because his parents had noted a mass in the lower back that increased in size over the last 4 to 5 months. On physical examination, a nevus flammeus was noted over the lumbar region of the back, with a 1×1-cm firm mass beneath it in the midline. A small dimple in the skin was seen at the center of the mass (Figure 1). History and results of the remainder of the physical examination were not contributory.
Magnetic resonance imaging and computed tomographic scans showed a cystic lesion at L-4 connected to the skin by a sinus tract. The mass was both intradural and extradural (Figure 2).
The patient's family agreed to elective surgical removal of the tumor; the patient did well postoperatively and was discharged home.
Microscopic sections are shown in Figure 3 and Figure 4.
Diagnosis and Discussion
Intraspinal Dermoid Cyst
Intraspinal dermoid cysts