Intraspinal dermoid cysts are rare and benign tumors that occur primarily due to the defective closure of the neural tube, an ectodermal derivative, during the process of development. They can appear subdurally, extramedullary or intramedullary, with intramedullary presentations being relatively rare.
We present here a 24-year-old lady with low backache radiating to both lower limbs, with tingling and numbness of both lower limbs for 3 years. MRI study of the lumbosacral spine revealed a heterogeneous intradural mass lesion in the conus medullaris region at L2-L3 level (low lying cord) displacing the traversing nerve roots. Total excision of the tumor was tone and sent for biopsy which revealed keratinocytes with keratin flakes, based on which a diagnosis of dermoid was made.