case_images: PMC6024502_01
case_images: Preoperative CT and MRI. (a-c) T1 and T2 weighted sagittal images showing intramedullary lesion at D8-9 level with faint peripheral enhancement on gadolinium contrast. (d and e) Preoperative CT dorsal spine axial and sagittal images: not showing any abnormality
case_images: SNI-9-122-g001.jpg
case_images: PMC6024502_01_SNI-9-122-g001.jpg
case_images: F1
case_images: T1, hyperintense on T2-weighted images, with a faint rim of enhancement with post gadolinium diethylenetriamine pentaacetate (GD-DTPA) injection [Figure 1]. The computed tomography (CT) was unremarkable.
case_images: Intraopeartive images. (a) Lesion surfacing after durotomy, (b) pearly white material seen during decompression of the tumor and (c) tumor cavity after decompression
case_images: SNI-9-122-g002.jpg
case_images: PMC6024502_01_SNI-9-122-g002.jpg
case_images: F2
case_images: It was pearly white and had a well-defined plane except posteriorly where capsule was densely adherent to the cord/parenchyma [Figure 2].
case_images: Histological images. (a and b): Photomicrograph of an epidermoid cyst with lamellated keratin. Adnexal structures were not seen. (H&E, x100)
case_images: SNI-9-122-g003.jpg
case_images: PMC6024502_01_SNI-9-122-g003.jpg
case_images: F3
case_images: Histopathology confirmed the diagnosis of an IEC; the epidermoid contained lamellated keratinous flakes, dystrophic calcification without adnexal structures, and an inflammatory response/giant cell formation [Figure 3].
case_images: Follow up MRI at 6 months. (a-c) T2 weighted sagittal, T1 gadolinium contrast and diffusion images: no evidence of recurrence. Post op changes noted. (Preoperative diffusion sequence was not available)
case_images: SNI-9-122-g004.jpg
case_images: PMC6024502_01_SNI-9-122-g004.jpg
case_images: F4
case_images: The follow-up contrast-enhanced MRI showed no residual/recurrent lesion [Figure 4].