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Arquivos de Neuro-Psiquiatria

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FONTENELLE FILHO, Oscar  and  DUARTE, Francisco. Intraspinal epidermoid and dermoid tumours. Arq. Neuro-Psiquiatr. [online]. 1971, vol.29, n.1, pp.26-40. ISSN 0004-282X.

Two cases of epidermoids and one case of dermoid intraspinal tumours are reported. The last case was located at thoracic level (T7) (case 3) and was epidural in localization. The two epidermoids tumours were located at the thoracic-lumbar (case 1) and lumbar (case 2) level, respectively; the first was intramedullary and the second subdural in localization. In two (cases 2 and 3) there was associated communicating pilonidal sinuses. One of the patients (case 3) was operated within the second month of age. The early discovery of the tumour in this patient was made through a lumbar raquimanometry that disclosed a complete subarachnoid block. In spite of this the patient did not presented any neurological symptoms. The authors are of opinion that in presence of a dermal fistula higher to lumbo-sacral spinal segment one must have in mind the possibility of intraspinal epidermoid or dermoid tumour, even in absence of neurological symptoms. The combination of long term clinical symptoms, radiographic evidence of pressure erosion, enlargement of the spinal canal and pilonidal sinus led to the correct preoperative diagnosis in case 2.

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