Anterior sacral meningocele completely occupied by an epidermoid tumor

A 2-year-old girl presented with an anterior sacral meningocele completely occupied by an epidermoid tumor. Preoperative magnetic resonance imaging ha d shown the meningocele with contents of the same intensity as cerebrospina l fluid. Surgery via a posterior sacral approach disclosed the tumor beneat h an unexpected membrane inside the meningocele. Additionally, the presence of pus inside epidermoid tumor suggested that possible episodes of asympto matic meningitis or other infection might have occurred before treatment, t hese being the major complication in anterior sacral meningocele. Therefore , we recommend that surgical treatment should be performed at the earliest possible stage in childhood, once the diagnosis is established, and dural p lasty carried out to prevent infectious complications.