Thoracic Intradural Extramedullary Epidermoid Tumor: Two Rare Cases

Intradural epidermoid tumors of the spinal cord are commonly associated with spinal cord dysraphism or invasive procedures. The spinal epidermoid tumor, frequently located intradural extramedullary region, is typically found in the lumbar region, and its placement in the thoracic region is rare. Furthermore, it is rarely observed without underlying spinal dysraphism or invasive intervention. The first case, a 52-year-old female patient was evaluated for back pain. On the thoracic magnetic resonance imaging (MRI) conducted, a 7-mm diameter intradural extramedullary non-enhancing nodular formation posterior to the T3 vertebra was detected. This lesion was completely excised via surgical intervention because of the increased size and the resultant hypoesthesia below T4 dermatome noted at follow-up. The second case, a 31-year-old woman presented with new-onset weakness in both legs. Notably, she has a history of a spinal mass lesion in the thoracic region 5 years ago. Thoracic MRI was performed to examine the recurrence, and it revealed a hypointense mass lesion axial plane with intradural extramedullary circumferential enhancement in the left posterior T6 level. This lesion was completely removed. No recurrence was noted at follow-up, and the histopathological diagnosis confirmed an epidermoid tumor. An isolated epidermoid tumor should be considered in the differential diagnosis of intradural -extramedullary mass lesions of the thoracic region. The tumor was successfully resected in its entirety via surgical intervention without any neurological deficit. Our cases support the fact that surgical resection is a crucial factor in recurrence.