Intramedullary epidermoid cyst of the thoracic spine without spinal dysraphism in a child: A rare case report with favorable surgical outcome

Intramedullary epidermoid cysts are extremely rare benign spinal lesions, especially in pediatric patients without associated spinal dysraphism or prior surgical history. We report a case of a 9-year-old female presenting with progressive spastic paraparesis and sensory deficits. Magnetic resonance imaging revealed a thoracic intramedullary lesion extending from T2 to T4. The patient underwent complete microsurgical excision via laminectomy and midline myelotomy. Histopathology confirmed an epidermoid cyst. Postoperatively, the patient showed significant neurological recovery, improving from American Spinal Injury Association Grade C to D within 3 months. This case highlights the importance of early diagnosis and complete surgical excision in achieving favorable outcomes.