Intracranial Dermoid Cyst Research Articles

Massive rupture of suprasellar dermoid cyst into ventricles

This 27-year-old man with a 2-year history of progressive visual loss in his left eye was admitted for an episode of sudden decreased level of consciousness and partial recovery with persistent confusion. Contrast-enhanced computerized tomography (CT) scanning revealed a sellar mass lesion with hypodense material floating on ventricular cerebrospinal fluid (CSF) (Fig. 1 left). Magnetic resonance (MR) images showed a tumor in the suprasellar region with the fat/fluid level spilling into the dilated ventricles (Fig. 1 center and right). The patient underwent a pterionofrontal craniotomy for resection of the tumor and a transient ventriculostomy. Postoperatively he made an excellent recovery. Intracranial dermoid cysts are rare congenital tumors that are usually benign and slow growing. Most arise in the midline basal cisterns and produce symptoms by interfering with spinal fluid pathways or vascular structures or by cyst rupture into the subarachnoid space or ventricular system. 1 The latter event releases keratin and cholesterol breakdown products that create irritation and may cause a chemical meningitis or ventriculitis that can be severe and long lasting. However, asymptomatic cases are not uncommon. 2,3 The imaging characteristics of dermoid cysts depend on the contents of the lesion. On CT scanning these lesions are demonstrated to be homogeneous, with an attenuation value similar to that of CSF. The hair and sebaceous content give the cyst a heterogeneous MR image signal, but the abundant lipid produces a high signal intensity on T 1-weighted images. Massive spilling of the sebaceous contents into the ventricles is shown as a fat/fluid level, with the fatty component floating on the fluid component.

Three-dimensional chemical shift-selective MRI of a ruptured intracranial dermoid cyst

Three-dimensional chemical shift-selective MRI of a ruptured intracranial dermoid cyst

Congenital dermal sinus with intracranial dermoid cyst

Summary We report a 3-year-old girl with a congenital dermal sinus associated with an intracranial dermoid cyst.

Immunohistochemical detection of carbohydrate determinant 19-9 (ca 19-9) in intracranial epidermoid and dermoid cysts

We evaluated carbohydrate antigen (CA) 19-9 levels of intracranial dermoid and epidermoid cyst in serum and intratumoral tissue. The preoperative serum levels were mildly to moderately higher than their normal ranges in four of seven patients. In four patients with high serum CA 19-9 levels, they returned to normal ranges in three who had the cyst resected totally and remained slightly high in one with residual cyst. Immunohistochemical studies using anti-CA 19-9 antibody demonstrated positively stained capsule and keratinous tissue. Serum CA 19-9 levels of intracranial dermoid or epidermoid cysts with more teratomatous components may be elevated above normal levels.

Dermoid of cavernous sinus resulting in isolated oculomotor nerve palsy

Intracranial dermoid cysts and acquired oculomotor nerve palsies are individually rare in childhood. This report describes a 4-year-old boy with acute oculomotor nerve palsy and pupillary sparing secondary to a dermoid within the lateral wall of the cavernous sinus. The clinical signs resolved after complete surgical excision of the tumor with no evidence of recurrence on computed tomography 1 year later. This is the first case report in childhood of a dermoid within the cavernous sinus and of an isolated oculomotor nerve palsy due to a dermoid cyst.

Dermoid cyst mimicking hematoma in the posterior fossa

Intracranial dermoid cysts are usually reported to be associated with long lasting or waxing-waning symptoms. Computer tomography (CT) scans usually depict such neoplasms as well-defined areas of low density. This report is about a case of a dermoid cyst, the acute clinical features and CT hyperdensity of which mimicked a hematoma in the posterior fossa. The association of acute onset with CT hyperdensity makes this case of dermoid cyst very unusual.

Supratentorial dermoid cysts

Supratentorial dermoid cysts are rare lesions. In eight cases presented here, the lack of recurrence after subtotal removal of the capsule and the good long-term prognosis are emphasized. This finding is in agreement with the literature. The frequent relationship of these lesions with the cavernous sinus suggests a vascular genesis in the development of intracranial dermoid cysts.

Surgical treatment of intracranial dermoid and epidermoid cysts in children

Between 1956 and 1987 operations were performed on 36 patients below the age of 20 years for epidermoid and dermoid cysts of the central nervous system. Seventeen tumors were intracranial intradural lesions (47%): 12 were located in the supratentorial region (71%) and 5 were located in the infratentorial region (29%). Ten of these tumors (59%) were seated along the midline structures. The clinical presentation was consistent with the location of the tumors. The neuroradiological diagnosis was mostly made with the aid of pneumoencephalography, computed tomography (CT), nonionic contrast medium CT cisternography, and magnetic resonance imaging. Complete removal of the tumor contents was performed in all cases but one, although the completeness of removal of the tumor capsule could not be exactly estimated in some patients. At late follow-up only two tumor recurrences were observed. Radical removal of the tumor capsule of these congenital tumors, even when it is connected to vital neurovascular structures, seems advisable in patients who become symptomatic within the first two decades of life.

Febrile convulsions in an adult as presenting symptom of intracranial dermoid cyst: a case report

A 32-year-old man had generalized tonic-clonic epileptic seizures associated with episodes of recurrent high fever for 6 years. Repeated physical examinations including neurological status, EEG and nuclear brain scan were negative. Brain CT showed a nonhomogeneous parasellar cyst of low density and fat-fluid levels in the lateral ventricles. The diagnosis of intracranial dermoid cyst was confirmed at surgery and histopathologically. Recurrent febrile convulsions and chemical meningitis may be the only clinical manifestations of ruptured dermoid cyst. The CT features of intracranial dermoid cyst are pathognomonic.

Persisting Intraventricular Fat-Fluid Levels following Surgery on a Ruptured Dermoid Cyst of the Posterior Fossa

Intracranial dermoid cysts occasionally rupture spontaneously into the ventricles or into the subarachnoid space. In such cases, intraventricular fat-fluid levels are invariably evident at computed tomography and may even be visible on a conventional radiograph of the skull. A case is described in which fat was observed to remain in the ventricles long after surgical removal of a dermoid cyst. We think that this fat, by causing obstruction of the cerebrospinal fluid pathways, should be regarded as a potential cause of intermittent elevation of intracranial pressure.

Radiolucent intracranial dermoid cyst. Report of an unusual case

An intracranial dermoid cyst presenting as a radiolucent mass on the plain radiographs of the skull is described.

Intraventricular fat-fluid level secondary to rupture of an intracranial dermoid cyst

Intracranial dermoid cysts are rare congenital tumors. Because of a slow growth pattern, these tumors may attain considerable size before discovery. Patients harboring these lesions generally have a long history of symptoms; average time between onset of symptoms and diagnosis is 8.5 years [1, 2]. The mode of presentation depends upon the size and location of the tumor. The clinical picture is nonspecific, and symptoms may include headache, seizures, dementia, and, occasionally, meningitis. Papilledema is often absent, and spinal tap is normal in more than half of the cases [3, 4]. Plain skull x-rays are often abnormal and may show a variety of changes. This case illustrates a previously unreported finding of an intraventricular fat-fluid level secondary to spontaneous rupture of a dermoid cyst.

Giant Intracranial Dermoid Cyst: Case Report and Review of the Literature on Intracranial Dermoids and Epidermoids

A 45-year old man was referred to the Johns Hopkins Hospital with a seven-year history of repeated episodes of light-headedness, increasing irriability and forgetfulness. Examinations revealed a right superior, incongruous quadrantanopsia. EEG showed an abnormality in the left temporal lobe, and a cerebral angiogram outlined an avascular mass in the left cerebral hemisphere. At operation, the patient was found to have a giant dermoid cyst involving the left frontal, temporal and parietal lobes. Over the last 30 years we have encountered only 6 cases of intracranial epidermoids and 3 cases of intracranial dermoids. These cases are cited, and a discussion of the embryology, histology, clinical characteristics, and treatment of these lesions with a review of the literature is undertaken.

Ruptured intracranial dermoid: Report of a case and survey of previously reported cases

1. 1. A case of ruptured intracranial dermoid cysts with ventriculitis and meningitis occurring in a forty-five year old woman has been described. 2. 2. A survey of all the cases of ruptured intracranial dermoid in the literature proved that the mortality among such patients is extremely high. 3. 3. Late surgical intervention has proved unsatisfactory in all intracranial dermoid cysts, and the importance of early recognition and surgical intervention is greatly stressed. A high degree of suspicion must always be maintained in all cases of meningitis with abnormal intracranial calcification.

INTRACRANIAL DERMOID CYSTS

Intracranial cysts of the dermoid type are seldom recognized clinically. It is doubtful whether any case of dermoid cyst of the brain has been diagnosed before operation. Occasionally one has been revealed at the operating table, but most of the cases have been reported from necropsy material. The presence of a crescentic shadow in roentgenograms, caused by a calcified area in the wall of the cyst, has been observed in two or three instances. The finding of similar shadows in cases of suspected brain tumor, while not pathognomonic, should at least suggest the possibility of a dermoid cyst. The whole subject of intracranial dermoid and epidermoid cysts, cholesteatomas and teratomas has become considerably confused in nomenclature, as the nature of the lesion depends not only on the cell layers from which these growths arise—be they epithelial or endothelial in origin—but also on the location and the nature of the contents