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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.29 no.1 São Paulo Mar. 1971

http://dx.doi.org/10.1590/S0004-282X1971000100003 

Tumores dermóides e epidermóides intra-espinhas

 

Intraspinal epidermoid and dermoid tumours

 

 

Oscar Fontenelle FilhoI; Francisco DuarteII

IChefe do Serviço de Neurocirurgia do Hospital Estadual Miguel Couto (Rio de Janeiro, GB)
IIChefe de Clínica e do Setor de Neuropatologia do Serviço de Anatomia Patológica do Hospital dos Servidores do Estado (Rio de Janeiro, GB)

 

 


RESUMO

São relatados dois casos de tumores epidermóides e um de tumor dermóide, todos intrarraquianos. Este último era de localização epidural ao nível da coluna torácica (caso 3); os dois tumores epidermóides situavam-se na coluna tóraco-lombar (caso 1) e lombar (caso 2), respectivamente, sendo o primeiro intramedular e o segundo intradural. Em dois casos (casos 2 e 3) os tumores associavam-se a fístula dérmica congênita. Um paciente (caso 3) foi operado aos dois meses de idade; a descoberta do tumor deveu-se à realização da raquimanometria que revelou bloqueio, apesar do paciente não apresentar qualquer sinal neurológico de compressão medular. Os autores são de opinião que, em presença de fístula dérmica congênita ao nível da coluna vertebral, principalmente quando localizada acima do segmento lombosacro, deve-se sempre suspeitar da possibilidade do tumor epidermóide ou dermóide intrarraquiano, mesmo na ausência de sinais neurológicos. A combinação de sintomas neurológicos de longa duração, a evidência radiológica de erosão e alargamento do canal raquiano e a história de fístula dérmica congênita proporcionaram o diagnóstico pré-operatório correto no caso 2.


SUMMARY

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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REFERÊNCIAS

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