Lateral ventricle epidermoid

Abstract

CASE SUMMARY A 16-year-old male patient presented to an outside ER complaining of a headache. A noncontrast CT (NCCT) head revealed an intraventricular midline cystic mass. A contrast CT (CCT) head demonstrated minimal intralesional septal enhancement (Figure 1). The patient was then transferred to a tertiary pediatric hospital, where a brain MRI demonstrated a large, lobulated and septated T2 hyperintense mass within the posterior bodies of the lateral ventricles (Figure 2). There was intermediate signal intensity on T2 FLAIR within the interstices of the cyst (Figure 3) and positive diffusion restriction of the mass (Figure 4). The lateral and third ventricles were mildly dilated with periventricular T2 hyperintensity consistent with transependymal edema/resorption. A gross total resection was performed. Pathology confirmed this lesion to be an intraventricular epidermoid within the lateral ventricles (Figure 5).