Intracranial Epidermoid Cyst: A Rare Case Series of 3 Patients

K S Sannidhi,A M ​ Amrutha,S N Madhusudan

doi:10.51131/ijpccr/v2i4.5

Abstract

Of the intracranial epidermoids, temporal pole, interhemispheric region and prepontine, premedullary and inter-peduncular cisterns epidermoid are rare and only few cases have been reported. This is a case series study of 3 patients with temporal pole, interhemispheric region and in prepontine, premedullary and inter-peduncular cisterns epidermoids surgically treated in our institution. The age at the time of presentation varied between 40 and 65 years and 2 were males and one female. The presenting feature was headache, giddiness and visual disturbances. On computerized tomography scan the lesions showed dense calcification. On magnetic resonance imaging, the lesions were located in the temporal pole, interhemispheric region and in prepontine, premedullary and inter-peduncular cisterns with heterogenous signal intensities. All 3 patients underwent surgical resection. Keywords: Temporal pole epidermoid cyst, Interhemispheric epidermoid cyst, Prepontine epidermoid cyst, Intracranial Epidermoid Cyst

Highlights

Epidermoids are benign, slow-growing congenital lesions and are most commonly located in the cerebellopontine angle, followed by the suprasellar cisterns, other locations include Sylvian fissure, brainstem, intraventricular, pineal regions, intradiploic space of skull, and spinal cord [1]. They are relatively uncommon, representing between 0.2% and 1.0% of all intracranial tumors,1 and are often located in the cornu Ammonis (CA), parapituitary region, diploë, rhomboid fossa and spinal cord [2,3]. They result from inclusion of ectodermal elements during neural tube closure, and typically present in middle age due to mass effect on adjacent structures
We describe 3 unusual cases of epidermoid cyst arising in the temporal pole, interhemispheric region and in prepontine, premedullary and inter-peduncular cisterns: development and radiological findings are discussed
Followed by which MRI was done for further characterization, which revealed an extra-axial, lobulated cystic mass, T1 hypointense, T2 hyperintense and FLAIR heterogenous signal intensity, measuring 48 × 30 × 36 mm, in the left temporal region with scalloping of the underlying parenchyma

Summary

Introduction

Epidermoids are benign, slow-growing congenital lesions and are most commonly located in the cerebellopontine angle, followed by the suprasellar cisterns, other locations include Sylvian fissure, brainstem, intraventricular, pineal regions, intradiploic space of skull, and spinal cord [1]. They are relatively uncommon, representing between 0.2% and 1.0% of all intracranial tumors, and are often located in the cornu Ammonis (CA), parapituitary region, diploë, rhomboid fossa and spinal cord [2,3]. Various symptoms may be present, including complex partial seizures and epileptic laughter [4,5,6], for which different surgical approaches have been adopted. We describe 3 unusual cases of epidermoid cyst arising in the temporal pole, interhemispheric region and in prepontine, premedullary and inter-peduncular cisterns: development and radiological findings are discussed

Case descriptions

Findings

Discussion